Farshad Mazda, Spirig José Miguel, Burkhard Marco D
Department of Orthopedic Surgery, Balgrist University Hospital, University of Zurich, Forchstrasse 340, 8008, Zurich, Switzerland.
Eur Spine J. 2022 Dec;31(12):3696-3702. doi: 10.1007/s00586-021-06906-0. Epub 2021 Jun 25.
Anomalous vertebral artery (VA) with loop formation is a rare cause of cervical nerve root compression. Various techniques with anterior and posterior approaches have been described for surgical treatment once conservative treatments fail. We herein present a case treated with the new technique of anterior release, distraction and fusion (ARDF) and further provide an updated review of surgically managed VA loops in the subaxial spine.
A 76-year-old female complained of a 6-year history of pulsating, shooting pain in her right arm to the thumb. After obtaining repeated MRI, the VA loop compressing the right-sided C6-nerve root was detected. A neurovascular decompression through ARDF which led to an indirect loop straightening was performed. The patient immediately improved after surgery and remained pain-free 1 year postoperative.
Neural irritation due to VA loop formation is a rare cause of cervical radiculopathy. While various surgical strategies have been described, we believe that anterior and anterolateral approaches are the safest to yield neurovascular decompression. We described and documented ARDF (anterior VA release, intervertebral distraction and fusion) on a patient case.
II (Diagnostic: individual cross-sectional studies with consistently applied reference standard and blinding).
椎动脉（VA）走行异常并形成袢是导致颈神经根受压的罕见原因。一旦保守治疗失败，已描述了多种采用前路和后路的手术技术来进行治疗。我们在此介绍一例采用前路松解、撑开和融合（ARDF）新技术治疗的病例，并进一步提供有关下颈椎节段VA袢手术治疗的最新综述。
一名76岁女性主诉右臂至拇指有6年搏动性、刺痛病史。多次MRI检查后，发现VA袢压迫右侧C6神经根。通过ARDF进行神经血管减压，间接使袢变直。患者术后立即好转，术后1年无疼痛。
VA袢形成引起的神经刺激是颈神经根病的罕见原因。虽然已描述了多种手术策略，但我们认为前路和前外侧入路是实现神经血管减压最安全的方法。我们在一个病例中描述并记录了ARDF（前路VA松解、椎间撑开和融合）。
II（诊断：采用一致应用的参考标准和盲法的个体横断面研究）。
Zotero 插件