From the Research
Yes, advanced degenerative changes in the lateral atlantoaxial joints bilaterally can cause dizziness and falls. These joints, located between the first (atlas) and second (axis) cervical vertebrae, play a crucial role in head rotation and stability. When degenerative changes occur here, they can compress nearby structures including the vertebral arteries that supply blood to the brain and brainstem, as well as affect proprioceptive nerve fibers that help with balance and spatial orientation. This compression may reduce blood flow to areas of the brain responsible for balance or disrupt normal proprioceptive signals, resulting in symptoms like dizziness, vertigo, unsteady gait, and increased fall risk.
Key Points to Consider
- The most recent study 1 from 2023, highlights the prevalence and radiographic features of atlantoaxial dislocation in adult patients with Kashin-Beck disease, which can lead to degenerative changes in the lateral atlantoaxial joints.
- A study from 2010 2 analyzed 108 patients with osteoarthritis of the atlantoaxial joints and resultant craniovertebral instability, and found that treatment with C1-2 lateral mass plate and screw method of atlantoaxial fixation and joint distraction using bone graft with or without the assistance of metal spacers can be an optimum form of treatment.
- Another study from 2007 3 evaluated the clinical and pathologic findings and surgical treatment outcomes for atlantoaxial osteoarthritis, and found that posterior atlantoaxial arthrodesis can provide significant pain relief in most patients.
Treatment Approach
Treatment typically involves a multidisciplinary approach including:
- Physical therapy focusing on neck stabilization exercises
- Pain management with NSAIDs or muscle relaxants
- Possibly cervical collars for temporary support
- In severe cases where conservative management fails, surgical intervention may be necessary to stabilize the joint and decompress neural structures.
Important Considerations
- Patients experiencing these symptoms should be evaluated by a neurologist or spine specialist for proper diagnosis and management, as similar symptoms can also result from other conditions.
- The decision to undergo surgical intervention should be made on a case-by-case basis, taking into account the severity of symptoms, the presence of any underlying conditions, and the patient's overall health status.