The effect of vertebral artery characteristics on cervical discogenic pain and disability

Introduction : Cervical discogenic pain, which is characterized by a stiffness or pain in neck movement, generally occurs as a result of disc degeneration. On the other hand; vascular pathologies of the cervical region, especially vertebrobasilar insufficiency, may give rise to similar findings in patients; it can also be detected simultaneously with cervical disc pathologies. . In this study, it was aimed to investigate whether the circulatory properties of the vertebral arteries have an effect on the neck pain and functional status of the patients. Material and Method: Based on the participants’ medical history, physical examination and radiological examination, sixty five patients were diagnosed with cervical disc herniation. Twenty patients who met the inclusion criteria were completed the study. Vertebral artery and carotid artery doppler ultrasonography was performed in these patients, thus any stenosis or insufficiency in vascular systems of the neck was evaluated. Additionally; vertebral blood flow rate (ml / min),vessel diameter(mm), minimum blood flow velocity (Vmin) and maximum blood flow velocity (Vmax) parameters was measured by doppler ultrasonography. The obtained findings compared with patients' level of pain measured with the "VAS (Visual Analog Scale)" and the level of daily life activities measured by the "Neck Disability Index ". Results: It was detected a statistically significant negative correlation between the VAS score and right vertebral artery diameter (p=0.019, r=-0.518). A significant reverse correlation between the VAS score and right vertebral arterial blood flow rate (p=0.011, r=-0.556) was also observed. No correlation was found between other vertebral artery parameters and VAS score or Neck Disability Index (p>0.05). Conclusion: The findings of this study revealed that there is a correlation between the vertebral artery flow rate and pain level. Clinicians must take into consideration vertebral pathologies in patients with neck pain because of this vital condition may accompany with various musculoskeletal pathologies such as cervical disc herniation.