Anterior Transposition of Anomalous Tortuous Vertebral Artery Causing Cervical Radiculopathy: A Report of 2 Cases and Review of Literature

Document Type

Article

Abstract

OBJECTIVE: Cervical radiculopathy secondary to compression from vertebral artery (VA) tortuosity is a rare entity. We describe successful transposition through an anterolateral approach of tortuous VA loops causing cervical radiculopathy. METHODS: Two patients with cervical radiculopathy (first case at C5-6 and second case at C3-4) secondary to anomalous VA loop compression underwent anterolateral approaches to the cervical spine for decompression and VA transposition. The anterior transverse foramina were drilled to unroof the VA loop, which was dissected free from the exiting nerve root. RESULTS: In both cases, the affected cervical nerve root was successfully decompressed with both radiographic and clinical improvements in radiculopathy symptoms. We found 8 other cases of VA transposition via either an anterolateral approach or a posterolateral approach described in the literature. Our second case of anterolateral VA transposition at the C3-4 level is the first case at this level and the highest level reported in the literature. CONCLUSIONS: Decompression using an anterolateral approach with direct microvascular transposition of the VA is a safe and effective treatment of this pathology and addresses the cause of radiculopathy more directly than the posterolateral approach.

Medical Subject Headings

Cervical Vertebrae (diagnostic imaging); Female; Humans; Microvascular Decompression Surgery (methods); Middle Aged; Radiculopathy (diagnostic imaging, surgery); Vertebral Artery (abnormalities, diagnostic imaging, surgery)

Publication Date

2-14-2017

Publication Title

World neurosurgery

E-ISSN

1878-8769

Volume

101

First Page

289

Last Page

295

PubMed ID

28192269

Digital Object Identifier (DOI)

10.1016/j.wneu.2017.01.129

This document is currently not available here.

Share

COinS