Ju Chang Il, Kim Jeong Mok, Kim Jong Gyu, Kim Seok Won, Lee Seung Myung
Department of Neurosurgery, Chosun University Hospital, Seo-gu, Gwangju, Republic of Korea.
Department of Neurosurgery, Chosun University Hospital, Seo-gu, Gwangju, Republic of Korea.
World Neurosurg. 2017 Aug;104:1049.e11-1049.e15. doi: 10.1016/j.wneu.2017.05.090. Epub 2017 May 24.
A 52-year-old woman had a 20-month history of progressive radiating pain in the left arm and numbness on C7 dermatome.
On physical examination, left head rotation aggravated the radiculopathic pain. For an anatomic diagnosis of the vertebral artery and nerve root, magnetic resonance angiography was performed (computed tomography angiography was not possible because of her dye allergy history). Magnetic resonance angiography showed a left vertebral artery loop entering at the C6-7 intervertebral foramen. Surgical microvascular decompression was performed by an anterior cervical approach and the loop of the artery was fixed using a sling technique. Postoperative computed tomography angiography showed that the left vertebral artery was retracted anteriorly and the C7 nerve root was decompressed in the intervertebral foramen at the left C6-7 level.
The patient's radiculopathic symptoms were improved and especially the aggravated pain by left head rotation subsided dramatically.
一名52岁女性有20个月的左臂进行性放射性疼痛及C7皮节麻木病史。
体格检查时,向左转头会加重神经根性疼痛。为明确椎动脉和神经根的解剖诊断,进行了磁共振血管造影(由于其有造影剂过敏史,无法进行计算机断层扫描血管造影)。磁共振血管造影显示左侧椎动脉襻自C6-7椎间孔进入。采用颈椎前路进行手术微血管减压,并使用吊带技术固定动脉襻。术后计算机断层扫描血管造影显示左侧椎动脉向前移位,左侧C6-7水平椎间孔处的C7神经根得到减压。
患者的神经根性症状得到改善,尤其是向左转头时加重的疼痛明显减轻。