Point of View
The authors provide data on the prevalence of corpuscles in various regions of the disc. However, if 95% confidence intervals are applied to these data, it emerges that in no region is the prevalence actually significantly greater in patients with vertigo than in patients with spondylosis or controls. There is only a trend toward greater prevalence. Statistical significance might have emerged had larger samples been used. In that event, there would be grounds for concluding that a greater prevalence of corpuscles somehow underlies the production of vertigo. Meanwhile, although the authors have shown that the mean density of corpuscles is significantly greater in patients with vertigo, the ranges of densities overlap considerably. Density of corpuscles, therefore, is unlikely to be a determinant, for there are too many patients who do not have vertigo who have densities higher than those of patients who do have vertigo.
In essence, Peng et al provide circumstantial evidence to support their carefully worded conclusion, namely that “ingrowth of Ruffini corpuscles may be related to vertigo of cervical origin.” The operative word is “may.” The present data are not conclusive, but they do provide a foundation for a model that could be explored in the future, in an effort to understand better this perplexing symptom.