title: The long-term follow-up of surgical treatment for cervical myelopathy with severe nape and upper arm pain caused by the anomalous vertebral artery: case report.
abstract: METHODS
  A case of cervical myelopathy with a severe nape and upper arm pain caused by anomalous bilateral vertebral arteries is reported.
  
  
  OBJECTIVE
  To report over six and a half years results of a microsurgical decompression for high cervical myelopathy with a severe pain of nape and upper arm resulting from spinal cord compression by the anomalous vertebral arteries.
  
  
  BACKGROUND
  Although symptomatic cases of anomalies of vertebral artery (VA), such as fenestration or elongation, leading to severe cervical pain, cervical myelopathy, or accessory nerve palsy have been reported, no long-term results of microsurgical decompression for those cases have been reported.
  
  
  METHODS
  The clinical features of the case and over 6(1/2) years results of microsurgical decompression by retracting the arteries with silicon tapes and a dural patch are reported. An etiology and the treatment of the cases are discussed with a review of the previous documented cases.
  
  
  RESULTS
  The cord compression was relieved surgically, and the patient's symptoms have improved after surgery throughout the follow-up period.
  
  
  CONCLUSIONS
  Anomalous vertebral arteries should be included in the differential diagnosis of the upper cervical lesion of unknown origin. The microsurgical decompression with presented technique has relieved the symptoms for over 6(1/2) years.
authors.affiliation: Department of Orthopaedic Surgery, Yamagata University, Faculty of Medicine, Yamagata, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Takei
authors.forename: Masaaki
authors.initials: M
authors.lastname: Sagae
authors.forename: Katsushi
authors.initials: K
authors.lastname: Chiba
authors.forename: Toshihiko
authors.initials: T
authors.lastname: Ogino
mesh_terms: D001132:Arm / Q000473:pathology / Q000601:surgery*; D002574:Cervical Vertebrae / Q000473:pathology / Q000601:surgery; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D019547:Neck Pain / Q000209:etiology / Q000473:pathology / Q000601:surgery*; D010146:Pain / Q000209:etiology / Q000473:pathology / Q000601:surgery; D013118:Spinal Cord Diseases / Q000209:etiology / Q000473:pathology / Q000601:surgery*; D013995:Time; D014711:Vertebral Artery / Q000002:abnormalities* / Q000601:surgery*