Valsalva ratio: Assessment of autonomic modulation in patients of cervical spondylosis

Background: Cervical spondylosis is a common progressive degenerative disorder of the human spine often caused by the natural aging process. Osteophytic formations contribute to biomechanical changes that result in neural and vascular compression. The spinal compression of the obliquely passing cervical nerve roots can result in possible autonomic imbalance in the body. Valsalva maneuver is a simple, non-invasive and cost effective means to assess the autonomic activity. The results are appreciably reproducible if done properly under standardized conditions. Valsalva ratio is an important index of the baroreflex-mediated bradycardia and gives a fair idea about the parasympathetic tone. Aim: The aim of our study was to assess the level of autonomic activity by studying the valsalva ratio in patients with cervical spondylosis and to compare it with healthy controls. Materials and methods: This prospective random case control study was conducted at Pt. B. D. Sharma PGIMS, Rohtak. The study sample comprised of group I consisting of thirty randomly selected age and sex matched healthy controls and group II of thirty patients diagnosed with cervical spondylosis (age group 30-60 years of either sex). Results: In our study, valsalva ratio was found to be significantly low (p<0.01) in patients of cervical spondylosis as compared to healthy individuals. Conclusion: Altered parasympathetic tone can predispose the patients to hemodynamic instability leading to adverse cardiovascular implications in the long run.