Our Experience in the Treatment of Vertebrobasilar Insufficiency Due to Cervical Spine Disorders

Abstract

This article defines vertebra-related causes of vertebrobasilar insufficiency in patients with the signs of tortuosity of segment VI of the VA. The aim of this study is to present the results of diagnostics of discirculatory phenomena in the vertebrobasilar system and to show their importance for differentiated surgical treatment of stenotic lesions of segment V1 of VA in pathological disorders of cerebral circulation in the VBS caused by osteochondrosis of the cervical spine. The following traditional methods are used in diagnostics: Doppler ultrasonography, multispiral computed tomography with contrast enhancement. Also using developed by the author method for determining VA reactivity and circulatory insufficiency in the vertebrobasilar system (VBS). Based on our methodology and criteria, patients were selected for different types of surgical treatment with clinical outcome prediction following interventions on the arteries of the VBS. To determine the pathologies of the intracranial segments of the vertebral and basilar arteries, taking into account the pathways of collateral compensation in the VBS, cerebral angiography is recommended before surgery on the arteries of the VBS. Reconstructive techniques used on segment VI of the VA will predictably show the best long-term clinical results. The excision of a tortuous segment VI of the VA may be effective in obtaining reliable results of successful interventions in the early postoperative period. The conservative treatment of the patients with multiple VBD lesions is possible. early outcomes of their use are satisfactory.

Chiropractic Management of Neck Pain Complicated by Symptomatic Vertebral Artery Stenosis and Dizziness

“…In general, there is no consensus regarding treatment for VBI [ 2 ]. However, common medical practices include anticoagulant and antiplatelet therapies, statins, blood pressure control [ 2 , 27 ], and lifestyle recommendations, including avoidance of smoking, and diet and exercise [ 17 ]. Endovascular treatments, including percutaneous transluminal angioplasty, stenting, and thrombectomy, are emerging as minimally invasive procedures for symptomatic vertebral artery stenosis [ 28 , 29 ].…”

“…However, a recent randomized controlled trial and systematic review found no significant differences with respect to stroke-related disability [ 29 ] and likelihood of stroke or transient ischemic attack with these therapies compared with standard medical treatment, suggesting that further research is needed [ 28 ]. Accordingly, endovascular treatments are typically reserved for those with a high grade of stenosis, persistent symptoms despite medical treatment, and/or stenosis at the vertebral artery origin [ 2 , 27 ]. To date, acupuncture has limited evidence for treating VBI [ 30 ].…”