Evaluation of Neck Proprioception, Vestibular Function, and Cervical Muscle Thickness in Patients with Cervical Spinal Stenosis: A Cross-Sectional Study

Abstract

Aim: This study aimed to examine the relationship between spinal canal diameter and cervical proprioception, vestibular function, and neck muscle thickness in patients with cervical spinal stenosis (CSS), compared with healthy controls. Material and Methods: This cross-sectional study included 23 patients diagnosed with CSS through radiological and clinical examination, and 23 healthy individuals as a control group. The severity of CSS was determined by measuring the cross-sectional area (CSA) of the thecal sac. Proprioception was evaluated using the cervical joint position error test (CJPET), balance with static posturography on a foam surface, and dizziness with the dizziness handicap inventory (DHI). Cervical vestibular function was assessed using cervical vestibular evoked myogenic potential (cVEMP) and subjective visual vertical (SVV) tests. The CSA of the sternocleidomastoid, longus capitis, and longus colli muscles was also measured. Results: The CSS group showed significantly greater CJPET deviation (p=0.032), foam surface balance scores with eyes open and closed (p=0.034 and 0.015, respectively), and DHI scores (p<0.001) compared to the control group. No significant differences were found in right ear cVEMP amplitude (p=0.222), P1 latency (p=0.781), N1 latency (p=0.945), and in left ear amplitude (p=0.916), P1 latency (p=0.156), and N1 latency (p=0.558). Similarly, no significant difference was observed in SVV values (p=0.862). Conclusion: CSS patients demonstrate increased dizziness and impaired balance and proprioception, independent of stenosis severity. These findings suggest that sensorimotor interventions may be beneficial for improving balance and proprioceptive function in CSS.

Keywords

• Cervical spinal stenosis
• dizziness
• proprioception
• balance

Servikal Spinal Stenozlu Hastalarda Boyun Propriosepsiyonu, Vestibüler Fonksiyon ve Servikal Kas Kalınlığının Değerlendirilmesi: Kesitsel Bir Çalışma

Abstract

Amaç: Bu çalışmanın amacı, servikal spinal stenoz (cervical spinal stenosis, CSS) hastalarında spinal kanal çapı ile servikal propriosepsiyon, vestibüler fonksiyon ve boyun kası kalınlığı arasındaki ilişkiyi, sağlıklı kontrollerle karşılaştırarak incelemektir. Gereç ve Yöntemler: Bu kesitsel çalışmaya, radyolojik ve klinik muayene ile CSS tanısı konulan 23 hasta ve kontrol grubu olarak 23 sağlıklı birey dahil edilmiştir. CSS şiddeti, tekal kese kesitsel alanı (cross-sectional area, CSA) ölçülerek değerlendirilmiştir. Propriosepsiyon, servikal eklem pozisyon hata testi (cervical joint position error test, CJPET), denge foam yüzey üzerinde statik posturografi ile ve baş dönmesi dizziness handicap inventory (DHI) ile değerlendirilmiştir. Servikal vestibüler fonksiyon, servikal vestibüler uyarılmış miyojenik potansiyel (cervical vestibular evoked myogenic potential, cVEMP) ve subjektif görsel dikeylik (subjective visual vertical, SVV) testleriyle incelenmiştir. Ayrıca, sternokleidomastoid, longus capitis ve longus colli kaslarının CSA değerleri de ölçülmüştür. Bulgular: CSS grubunda, kontrol grubuna kıyasla anlamlı derecede daha yüksek CJPET sapması (p=0,032), gözler açık ve kapalı foam yüzey denge skorları (sırasıyla p=0,034 ve p=0,015) ve DHI skoru (p<0,001) bulunmuştur. Sağ kulak cVEMP genliği (p=0,222), P1 latansı (p=0,781), N1 latansı (p=0,945) açısından ve sol kulak cVEMP genliği (p=0,916), P1 latansı (p=0,156) ve N1 latansı (p=0,558) açısından anlamlı bir fark saptanmamıştır. Benzer şekilde, SVV değerleri açısından da anlamlı bir fark görülmemiştir (p=0,862). Sonuç: CSS hastalarında, stenoz şiddetinden bağımsız olarak artmış baş dönmesi ile birlikte denge ve propriosepsiyon bozukluğu gözlenmiştir. Bu bulgular, CSS'de denge ve proprioseptif fonksiyonların iyileştirilmesinde sensörimotor müdahalelerin faydalı olabileceğini düşündürmektedir.

Keywords

• Servikal spinal stenoz
• baş dönmesi
• propriosepsiyon
• denge

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