I’m gratified to hear that my wife is not the only patient experiencing post-cervical fusion light headedness/vertigo, an apparent occasional complication of this surgery. Fortunately, we have been blessed with physical therapists who have provided us with effective treatment. First, a bit of history.
Several years ago, as a result of an auto accident, she began experiencing vertigo. Our early efforts led to a diagnosis of benign vestibular (ear) vertigo, but it took some time to locate a PT with adequate diagnostic skills to identify the offending semicircular canal and successfully treat the problem. He not only restored her balance, but taught me how to diagnose the offending canal and perform the correct maneuver for DIY treatment at home. Over the next few years, I was able to help my wife several times.
Fast forward to the present. Three months ago, she had fusion of C4-C7 and experienced the usual issues of difficult swallowing, etc. About two months post-surgery, healing was progressing well, but my wife began to have bouts of dizziness and instability - a great concern at her age because of risk of falling. Our neurosurgeon's team seemed puzzled when we brought this up. We went back to our PT who had helped so much with her vertigo, and he ruled out any vestibular involvement. Soon after, she saw a second PT for routine treatment of other issues. She disclosed the problem she was having and mentioned the first PT’s findings, and he agreed.
He then began a course of therapy that he believed would help reposition the sphenoid bone, which is within the head and has attachments to the chewing muscles and others of the head and neck. The maneuver consisted of a second person sitting by the bed, placing the fingers of both hands at the base of the skull (the occiput) while the patient is lying face up with the head at the edge of bed, legs lifted with calves resting on a stool. With the fingers in place, cradling the head, lift up and back to apply traction to the neck. The word lift is meant to apply force in that direction as well as toward the top of the head. Continue this for four or five minutes, occasionally rotating the relaxed head and neck to the right, then left, then gently up and back.
The above is a simplified version of what our PT did, but works and is easy to do. Although I understand the anatomy of the sphenoid and its muscle attachments, I am also inclined to believe that this procedure may simply put traction on the neck and associated vascular structures to resolve the issue. This procedure restores balance 90% of the time, although it may take as much as an hour before the patient feels stable. Be sure to take the patient’s hands and help them back to a sitting position with legs over the bedside for a minute before attempting to stand.
I am committed to doing this twice a day until I can prove that my wife’s condition is stable.
I do believe, having read a number of similar accounts of post-cervical fusion vertigo/disorientation that this should be on the same list of possible post-op symptoms that are disclosed and explained to the patient before surgery.
@jsbigsky I'm sorry it took me awhile to see your helpful post. Thank you for your account of physical therapy. My PT does this same thing with me and often, probably every time I see her. I had a lot more issues with dizziness and vertigo before my cervical fusion and mine was just a single level C5/C6. It hasn't happened since my fusion. Perhaps the length of the fused levels may influence if this issue can happen. That's just a guess on my part. Before my surgery, I had a lot of vertebrae rotating on their own and that was exacerbated because I also have a condition called thoracic outlet syndrome (TOS) that makes one side of my neck tighter and adds to the rotation spasm.
I'm glad you can do this home therapy for your wife. I do a lot of things I've learned from my physical therapist as my normal maintenance too.
Jennifer