Microvascular decompression of a vertebral artery loop causing cervical radiculopathy: illustrative case

Area of Science:

• Neurosurgery
• Vascular Neurology

Background:

• Vertebral artery loops are an uncommon etiology of cervical radiculopathy.
• Surgical interventions for nerve root decompression involve anterior or posterior approaches, potentially with microvascular decompression.

Purpose of the Study:

• To present a case of cervical radiculopathy caused by a vertebral artery loop.
• To evaluate the efficacy of a posterior surgical approach for managing this condition.

Main Methods:

• A case report of a 49-year-old male with C4 nerve root compression due to a vertebral artery loop.
• Surgical intervention involved posterior cervical decompression, instrumented fusion, and macrovascular decompression.
• A literature review identified 20 similar surgically managed cases.

Main Results:

• The patient experienced resolution of neck pain and migraines post-surgery.
• The posterior approach, though less common than the anterior approach, proved effective.
• This represents the third reported case utilizing this specific posterior surgical strategy with a favorable outcome.

Conclusions:

• A posterior surgical approach is a safe and effective treatment for cervical radiculopathy caused by vertebral artery loops.
• This approach, combined with microvascular decompression, can yield good patient outcomes.