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On closely assessing the final part of the reflex, it is found that the neural fibers of the medial vestibulospinal tract reach the motoneurons of the spinal cord at the C2 and C5 levels and then enter the SCM through the spinal accessory nerve.
In cases of cervical spine surgery, postoperative vertigo might be attributable to intraoperative cervical spine trauma and injuries of central vestibular pathways, the vestibulospinal tract, neck receptors in neck muscles, and ligamentous structures.
The neurologic reflex produced by a peripheral vestibular disorder through the brainstem, instead of resulting in nystagmus, stimulates the vestibulospinal tract. The cervical muscles are the closest of the stimulated muscles.