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

Author

Semonche, Alexa, Rinaldo, Lorenzo, Lee, Young, Dubnicoff, Todd, Matles, Harlan, Chou, Dean, Abla, Adib, and Chang, Edward

Subjects
cervical radiculopathy, microvascular decompression, vertebral artery loop
Abstract

BACKGROUND: Vertebral artery loops are a rare cause of cervical radiculopathy. Surgical options for nerve root decompression include an anterior or posterior approach, with or without additional microvascular decompression. OBSERVATIONS: The authors describe a case of a 49-year-old man with a long-standing history of left-sided neck pain and migraines, who was found to have a vertebral artery loop in the left C3-4 neural foramen compressing the left C4 nerve root. The patient underwent a posterior cervical decompression with instrumented fusion and macrovascular decompression of the left C4 nerve root via Teflon felt insertion. In a literature review, we identified 20 similar cases that had also been managed surgically. LESSONS: Although the anterior approach is more frequently described in the literature, a posterior approach for nerve compression by a vertebral artery loop is also a safe and effective treatment. The authors report the third case of this surgical approach with a good outcome.

Published
2024

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