A New Sling Technique in Cervical Radiculopathy Caused by Vertebral Artery Loop Compression

A 52-year-old woman had a 20-month history of progressive radiating pain in the left arm and numbness on C7 dermatome.

On physical examination, left head rotation aggravated the radiculopathic pain. For an anatomic diagnosis of the vertebral artery and nerve root, magnetic resonance angiography was performed (computed tomography angiography was not possible because of her dye allergy history). Magnetic resonance angiography showed a left vertebral artery loop entering at the C6-7 intervertebral foramen. Surgical microvascular decompression was performed by an anterior cervical approach and the loop of the artery was fixed using a sling technique. Postoperative computed tomography angiography showed that the left vertebral artery was retracted anteriorly and the C7 nerve root was decompressed in the intervertebral foramen at the left C6-7 level.

The patient's radiculopathic symptoms were improved and especially the aggravated pain by left head rotation subsided dramatically.