Correlation of Vertebral Artery Parameters on Color DopplerUltrasound and Symptom of Vertigo in Cases of Cervical Spondylosis-A Prospective Analysis of 60 Cases

Introduction: Degenerative changes of the cervical spine, symptomatic or asymptomatic condition are associated with malfunction in vertebral artery blood flow affecting brain and vestibulocochlear organ bold flow presenting with various symptoms like Vertigo, neck pain, rigidity. So far the evaluation of vertebral arteries has been done by angiography with a limited data on evaluation with duplex scanning of the vertebral arteries and the role of duplex ultrasound in identifying the external compression of the vertebral artery has not been extensively studied. Hence the present study was undertaken to study the Doppler parameters like systolic velocity and flow volume of the vertebral artery with association of the color Doppler characteristics to the symptom of vertigo related to vertebobasal insufficiency. Aim: To study association between symptom of vertigo with Color Doppler findings of Vertebral artery diameter, Vertebral artery blood flow volume and Vertebral artery velocity. Materials and Methods: It is a Prospective analytical Study, conducted in Radiology Department of a Tertiary care Teaching institute in Central India, with a total 60 cases aged over 35 years with the clinical diagnosis of Cervical Spondylosis. Characteristics of the vertebral artery were recorded in terms of Peak systolic Velocity, Time averaged maximum velocity, The Diameter of the Segment in gray scale in millimetres and Flow volume of the vertebral artery and were later correlated to Vertigo using chi square test, student t test and z test with p values < 0.05 being considered statistically significant. Results: A total 60 patients with clinical diagnosis of cervical spondylosis were included. Majority of patients were in the age group 41 50 years [30 (50%)]. Among cases 39 (65%) were males and 21 (35%) females. Vertigo was noted in 35 (58.3%) cases. Vertebral artery diameter less than or equal to 3 mm on the right side was associated with vertigo in 55.5% cases. There is no statistically significant correlation between Vertigo and Vertebral artery diameter on the Right side (p = 0.77). A similar observation is made for the correlation between Vertigo and Vertebral artery diameter on the Left side too (p value = 0.48). Reduced blood flow volume of the vertebral artery (less than or equal to 100 ml/min) on the right side was associated with Vertgo in 53.3% of cases of Cervical Spondylosis. The association was statistically insignificant on both right and left side. Decreased Vertebral artery blood flow velocity (of less than or equal to 30 cm/s), 11 (78.5%) had vertigo was associated with vertigo on Right side in 52.2% cases. There was no significant correlation between right Vertebral artery blood flow velocity and vertigo (p = 0.07). However, on the left side the association was significant (p = 0.01). Conclusion: Whereas reduced vertebral artery diameter or decreased vertebral artery blood flow volume alone does not contribute to vertigo, (the decreased) blood flow velocity of at least one vertebral artery may contribute to development of vertigo.