Maegawa Tatsuya, Kohara Kotaro, Okumura Eitaro, Hashimoto Ryo, Kubota Motoo
Department of Spinal Surgery, Kameda Medical Center, Chiba, Japan.
J Neurosurg Case Lessons. 2025 Feb 10;9(6). doi: 10.3171/CASE24752.
Diagnosing cervical radiculopathy with root anomalies is difficult, as cervical nerve root anomalies are rare. Here, the authors report the rare case of a conjoined nerve root variant confirmed using full endoscopic cervical foraminotomy (FECF).
A 40-year-old female presented with painful numbness and paresis in the right upper limb. Physical examination revealed multiple radiculopathies in the C6 and C7 nerve roots. However, magnetic resonance imaging and computed tomography did not reveal any lesions explaining the right C7 radiculopathy. Furthermore, the right C6 root block injection had no effect, whereas the right C7 root block injection was extremely effective. FECF revealed a conjoined nerve root variant in the right C6-7 intervertebral foramen.
The study revealed that single nerve root block injections can be useful for pain relief as well as diagnosis of the affected level. Although the current case is rare, the report revealed that a lesion at a single intervertebral foramen can cause multiple radiculopathies. The study also highlighted the importance of careful examination of the clinical symptoms and the limitations of imaging tools. https://thejns.org/doi/10.3171/CASE24752.
由于颈神经根异常罕见,诊断伴有神经根异常的神经根型颈椎病很困难。在此,作者报告了一例经全内镜下颈椎椎间孔切开术(FECF)确诊的罕见的联合神经根变异病例。
一名40岁女性出现右上肢疼痛性麻木和轻瘫。体格检查发现C6和C7神经根多处神经根病。然而,磁共振成像和计算机断层扫描未发现任何可解释右侧C7神经根病的病变。此外,右侧C6神经根阻滞注射无效,而右侧C7神经根阻滞注射极为有效。FECF显示右侧C6 - 7椎间孔存在联合神经根变异。
该研究表明,单神经根阻滞注射对于缓解疼痛以及诊断受累节段可能有用。尽管当前病例罕见,但该报告显示单个椎间孔处的病变可导致多处神经根病。该研究还强调了仔细检查临床症状的重要性以及成像工具的局限性。https://thejns.org/doi/10.3171/CASE24752 。