Abstract:

Objective　 To explore imaging features and pathomechanism of cervical spondylotic vertebral artery insufficiency.　Methods　Sixty cases with cervical spondylotic vertebral artery insufficiency were included in this study, with the average age of 52(from 35 to 68), the average medical record of 4 months (the longest of 2 years), and the 2 times' of intermittent vertigo at least. Systematic imaging examinations were carried out for every case, including cervical anteroposterior, lateral and dynamic X-ray films, MRI, MRA and transcranial doppler (TCD) scan.　Results　X-ray films showed the healthy cases(3), the cases of straightforward changes of cervical curve(10) , the cases of degenerative changes(44), and the cases of cervical instability(3) respectively. However, MRI showed degenerative changes in 42 cases, and the compression of cervical dura resulting from cervical intervertebral disc hernia or the fold of ligamentum flavum in 18 cases. MRA examinations showed the normal ones in 38 cases, the slim change of unilateral vertebral artery in 10 and  the tortuosity in 12 cases，without obvious vertebral artery occlusion. TCD examination showed the normal flow velocity of vertebrobasilar artery in 8 cases and the significant abnormal in others.　Conclusions　The underlying mechanism of cervical spondylotic vertebral artery insufficiency focuses on the vessel contraction or spasm of vertebral artery caused by nerve irritation resulting from degenerative cervical segmental hypermobility and inflammatory reaction.

Key words: Cervical spondylosis, Vertebral artery insufficiency, Etiology mechanism