Detwiler P W, Porter R W, Harrington T R, Sonntag V K, Spetzler R F
Division of Neurological Surgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona 85013-4496, USA.
J Neurosurg. 1998 Sep;89(3):485-8. doi: 10.3171/jns.1998.89.3.0485.
Vertebral artery tortuosity and loop formation are rare causes of cervical radiculopathy. The authors present the case of a 70-year-old man with 9 years of progressive right-sided cervical and scapular pain but no history of trauma. Computerized tomography myelography and magnetic resonance imaging revealed an ovoid mass in the right C3-4 intervertebral foramen. The patient underwent a right C-3 and C-4 hemilaminectomy and a complete C3-4 facetectomy. A pulsatile vascular structure was found compressing the right C-4 nerve root. The bone overlying the vascular structure was removed, producing decompression of the nerve root. Immediate postoperative angiography showed that this lesion was a focal vertebral artery loop. The patient's symptoms resolved after surgery, supporting the use of vascular decompression of a cervical nerve root compressed by a vertebral artery loop for the relief of radicular symptoms.
椎动脉迂曲和襻形成是神经根型颈椎病的罕见病因。作者报告了一例70岁男性患者，有9年进行性右侧颈部和肩胛部疼痛病史，但无外伤史。计算机断层扫描脊髓造影和磁共振成像显示右侧C3 - 4椎间孔有一个椭圆形肿块。患者接受了右侧C3和C4半椎板切除术及完整的C3 - 4小关节切除术。发现一个搏动性血管结构压迫右侧C4神经根。去除血管结构上方的骨质，使神经根减压。术后立即进行的血管造影显示该病变为局灶性椎动脉襻。患者术后症状缓解，支持对由椎动脉襻压迫的颈神经根进行血管减压以缓解神经根症状。
