400 Section - CERVICO-GUT SYNDROME: GASTROINTESTINAL SYMPTOMS ASSOCIATED WITH CERVICAL SPONDYLOSIS AND THEIR IMPROVEMENT FOLLOWING MINIMUM INTERVENTIONS — A PROSPECTIVE SINGLE-BLIND COHORT STUDY

Objectives : Cervical spondylosis is commonly associated with pain, radiculopathy, and dizziness. Gastrointestinal (GI) disturbances such as nausea, burping, abdominal heaviness, and appetite loss are less recognized, described as “neck–stomach syndrome” [1,2] and linked to a proposed “gut–disc axis” [3]. Prospective evidence is limited.

Design: This single-blind cohort study was conducted at Purple Heron Hospital between November 2022 and April 2025, with the last enrolled patients completing 6-month follow-up in October 2025. A total of 160 adults with clinically and radiologically confirmed cervical spondylosis were enrolled. Diagnosis required positive provocative tests (Spurling’s, cervical compression/distraction) and MRI confirmation of degenerative pathology. Group A (n=80) received conservative management (medications, rehabilitation), while Group B (n=80) underwent minimum interventions (C-Arm guided interlaminar, foraminal, and facetal blocks) plus rehabilitation. Outcomes were assessed at baseline, 3 and 6 months using Visual Analogue Scale (VAS) for neck pain, Neck Disability Index (NDI), and a modified Gastrointestinal Symptom Rating Scale (GSRS) capturing nausea, burping, and appetite loss. These tools were chosen for their high specificity and sensitivity in grading symptom severity. The primary endpoint was ≥50% reduction in GI burden at 6 months.

Results: All patients reported baseline GI symptoms (mild 30%, moderate 50%, severe 20%). At 6 months, 55% of the conservative group achieved ≥50% reduction, while 95% of the interventional group improved, including 40% with complete remission (absolute risk difference 40%, RR 1.73, NNT≈3; p< 0.001). Cervical outcomes (VAS, NDI) correlated strongly with GI improvement (r=0.61, p< 0.001).

Conclusion: GI disturbances are prevalent in cervical spondylosis and improve significantly with minimum interventions. These findings substantiate Cervigo-Gut Syndrome as a clinically relevant neurogenic entity.