Vascular decompression of a vertebral artery loop producing cervical radiculopathy. Case report.
Vertebral artery tortuosity and loop formation are rare causes of cervical radiculopathy. The authors present the case of a 70-year-old man with 9 years of progressive right-sided cervical and scapular pain but no history of trauma. Computerized tomography myelography and magnetic resonance imaging revealed an ovoid mass in the right C3-4 intervertebral foramen. The patient underwent a right C-3 and C-4 hemilaminectomy and a complete C3-4 facetectomy. A pulsatile vascular structure was found compressing the right C-4 nerve root. The bone overlying the vascular structure was removed, producing decompression of the nerve root. Immediate postoperative angiography showed that this lesion was a focal vertebral artery loop. The patient's symptoms resolved after surgery, supporting the use of vascular decompression of a cervical nerve root compressed by a vertebral artery loop for the relief of radicular symptoms.
Division of Neurological Surgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona 85013-4496, USA.
P W
PW
Detwiler
R W
RW
Porter
T R
TR
Harrington
V K
VK
Sonntag
R F
RF
Spetzler
D000368:Aged; D000792:Angiography; D002574:Cervical Vertebrae / Q000098:blood supply / Q000601:surgery; D005500:Follow-Up Studies; D006801:Humans; D007796:Laminectomy; D008279:Magnetic Resonance Imaging; D008297:Male; D009192:Myelography; D019547:Neck Pain / Q000209:etiology; D009408:Nerve Compression Syndromes / Q000209:etiology*; D012540:Scapula; D013126:Spinal Nerve Roots / Q000473:pathology*; D014057:Tomography, X-Ray Computed; D014652:Vascular Diseases / Q000150:complications / Q000601:surgery; D014711:Vertebral Artery / Q000601:surgery*