@rkoepke
Have you had an updated MRI on your cervical spine and MRI of your head? I have had dizziness/balance issues and had ACDF surgery on C5-C6 which resolved many symptoms but still have a little dizziness/balance problems but not sure if tied to medications, small fiber neuropathy or blood flow. I was also diagnosed with sensorineural hearing loss which may impact this, too.

Have you been tested for peripheral artery disease, small fiber neuropathy, iron deficiency or thyroid dysfunction?

@rkoepke Vertigo can be a physical problem. I had it when muscle spasms were rotating my C1 and C2 independently. A physical therapist may help as it did me. The vertebral arteries run inside the sides of the cervical vertebrae, so twisting them stretches them, and can cause vertigo.

Have you been evaluated by a physical therapist?

YES ! i had c4-7 fused, And had the exact same symptoms. I've been to many Dr's and specialists since. Everything seems to come back normal. However, I have a GREAT pt. Over the past few years of seeing all these symptoms, just recently he took me thru kind of a eye test, seeing if my eyes and brain are tracking together. As well as he has me doing new exercises at home. Since my surgery, and my body trying to compensate for everything that's changed, my neck posture has changed which definitely can produce these symptoms. I seem to have more forward neck positioning than ever before. I'm doing a exercise trying to retrain my neck muscles to go back to normal, and it has helped. I don't know if this can help you, but HOPE so, cause it's miserable.