Department of Neurosurgery, Neurocenter of Southern Switzerland, Regional Hospital of Lugano, Lugano, Switzerland.
Pain Management Center, Neurocenter of Southern Switzerland, Regional Hospital of Lugano, Lugano, Switzerland.
Pain Pract. 2020 Sep;20(7):787-791. doi: 10.1111/papr.12903. Epub 2020 May 7.
We describe a case of a patient suffering with cervical radiculopathy due to vertebral artery loop with nerve root compression, treated with an epidural steroid injection. A 37-year-old man presented with a 2-year history of right-sided radicular pain along the C7 dermatome. Imaging showed a right-sided loop of the vertebral artery at the V1-V2 transition with contact on the C7 nerve root. The pain was resistant to conservative treatment, and the decision was made to perform a focused fluoroscopy-guided translaminar epidural steroid injection near the C7 nerve root. The procedure was uneventful, and the symptoms resolved completely after the procedure. Targeted epidural steroid injection might be a useful and safe diagnostic and therapeutic approach in patients affected by cervical radiculopathy due to a VA loop. To our knowledge, this is the first case of a VA loop associated with cervical radiculopathy treated with this technique.
我们描述了一例因椎动脉环神经根受压引起的颈椎病患者，采用硬膜外类固醇注射治疗。一名 37 岁男性出现右侧 C7 皮节沿神经根的根性疼痛 2 年。影像学显示 V1-V2 交界处右侧椎动脉呈环型，与 C7 神经根接触。疼痛对保守治疗无反应，决定在 C7 神经根附近进行有针对性的荧光透视引导下经皮硬膜外类固醇注射。该过程顺利，术后症状完全缓解。靶向硬膜外类固醇注射可能是一种有用且安全的诊断和治疗方法，适用于因 VA 环引起的颈椎病患者。据我们所知，这是首例采用该技术治疗的与 VA 环相关的颈椎病病例。
