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Vertebral artery loop--a cause of cervical radiculopathy
Salvatore Chibbaro1, Giuseppe Mirone, Muneyoshi Yasuda
1Department of Neurosurgery, Laribosiere University Hospital, Paris, France. schibbaro@hotmail.com
Objective:
To report a case of cervical radiculopathy caused by an anomalous vertebral artery (VA) and illustrate the efficacy of microvascular decompression by the anterolateral approach.
Methods:
A 50-year-old woman was referred because of an 8-year history of progressive left C6 radiculopathy refractory to other forms of treatment, including C5-6 anterior cervical discectomy. Clinical and radiologic evaluation showed an abnormally tortuous loop of V2 causing direct neurovascular compression.
Results:
A left cervical anterolateral approach was used to expose the anomalous loop. After a generous bony decompression, the loop was identified, and the artery was mobilized and ultimately separated from the C6 nerve root removing the direct pulsatile compression.
Conclusions:
Cervical root compression by an aberrant or anomalous extracranial VA is a rare cause of radiculopathy. The best management of such lesions is the anterolateral approach with bony and direct microvascular decompression.
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