Cervical Radiculopathy Caused by a Vertebral Artery Loop: Is a Focused Fluoroscopic-Guided Cervical Epidural Steroid Injection a Possible Treatment Modality?
cervical radiculopathy
epidural steroid injection
vertebral artery loop
Journal
Pain practice : the official journal of World Institute of Pain
ISSN: 1533-2500
Titre abrégé: Pain Pract
Pays: United States
ID NLM: 101130835
Informations de publication
Date de publication:
09 2020
09 2020
Historique:
received:
11
03
2020
revised:
08
04
2020
accepted:
14
04
2020
pubmed:
20
4
2020
medline:
22
12
2020
entrez:
20
4
2020
Statut:
ppublish
Résumé
We describe a case of a patient suffering with cervical radiculopathy due to vertebral artery loop with nerve root compression, treated with an epidural steroid injection. A 37-year-old man presented with a 2-year history of right-sided radicular pain along the C7 dermatome. Imaging showed a right-sided loop of the vertebral artery at the V1-V2 transition with contact on the C7 nerve root. The pain was resistant to conservative treatment, and the decision was made to perform a focused fluoroscopy-guided translaminar epidural steroid injection near the C7 nerve root. The procedure was uneventful, and the symptoms resolved completely after the procedure. Targeted epidural steroid injection might be a useful and safe diagnostic and therapeutic approach in patients affected by cervical radiculopathy due to a VA loop. To our knowledge, this is the first case of a VA loop associated with cervical radiculopathy treated with this technique.
Substances chimiques
Glucocorticoids
0
Triamcinolone
1ZK20VI6TY
Types de publication
Case Reports
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
787-791Informations de copyright
© 2020 World Institute of Pain.
Références
Paksoy Y, Levendoglu FD, Ogün CO, Ustün ME, Ogün TC. Vertebral artery loop formation: a frequent cause of cervicobrachial pain. Spine. 2003;28:1183-1188.
Ekşi MŞ, Toktaş ZO, Yılmaz B, et al. Vertebral artery loops in surgical perspective. Eur Spine J. 2016;25:4171-4180.
Wakao N, Takeuchi M, Nishimura M, et al. Risks for vascular injury during anterior cervical spine surgery: prevalence of a medial loop of vertebral artery and internal carotid artery. Spine. 2016;41:293-298.
Park SB, Yang H-J, Lee SH. Medial loop of v2 segment of vertebral artery causing compression of proximal cervical root. J Korean Neurosurg Soc. 2012;52:513-516.
Hadley LA. Tortuosity and deflection of the vertebral artery. Am J Roentgenol Radium Ther Nucl Med. 1958;80:306-312.
Bruneau M, Cornelius JF, Marneffe V, Triffaux M, George B. Anatomical variations of the V2 segment of the vertebral artery. Neurosurgery. 2006;59(suppl 1):ONS-20-ONS-24.
Curylo LJ, Mason HC, Bohlman HH, Yoo JU. Tortuous course of the vertebral artery and anterior cervical decompression: a cadaveric and clinical case study. Spine. 2000;25:2860-2864.
Hage ZA, Amin-Hanjani S, Wen D, Charbel FT. Surgical management of cervical radiculopathy caused by redundant vertebral artery loop. J Neurosurg Spine. 2012;17:337-341.
Khansuheb MZ, Kouznetsov E, Manchak M, Durrani Q, Drofa A. Vertebral artery sacrifice: novel strategy in treatment of vertebral artery loop. World Neurosurg. 2019;134:280-283.
Ju CI, Kim JM, Kim JG, Kim SW, Lee SM. A new sling technique in cervical radiculopathy caused by vertebral artery loop compression. World Neurosurg. 2017;104:1049.e11-1049.e15.
Oga M, Yuge I, Terada K, Shimizu A, Sugioka Y. Tortuosity of the vertebral artery in patients with cervical spondylotic myelopathy. Risk factor for the vertebral artery injury during anterior cervical decompression. Spine. 1996;21:1085-1089.
Kim HS, Lee JH, Cheh G, Lee S-H. Cervical radiculopathy caused by vertebral artery loop formation: a case report and review of the literature. J Korean Neurosurg Soc. 2010;48:465-468.
Sakaida H, Okada M, Yamamoto A. Vascular reconstruction of a vertebral artery loop causing cervical radiculopathy and vertebrobasilar insufficiency. Case report. J Neurosurg. 2001;94(suppl):145-149.
Danziger J, Bloch S. The widened cervical intervertebral foramen. Radiology. 1975;116:671-674.
Zimmerman HB, Farrell WJ. Cervical vertebral erosion caused by vertebral artery tortuosity. Am J Roentgenol Radium Ther Nucl Med. 1970;108:767-770.
Duthel R, Tudor C, Motuo-Fotso MJ, Brunon J. Cervical root compression by a loop of the vertebral artery: case report. Neurosurgery. 1994;35:140-142.
Sharma RR, Parekh HC, Prabhu S, Gurusinghe NT, Bertolis G. Compression of the C-2 root by a rare anomalous ectatic vertebral artery. Case report. J Neurosurg. 1993;78:669-672.
Tonsbeek AM, Groen JL, Vleggeert-Lankamp CLAM. Surgical interventions for cervical radiculopathy caused by a vertebral artery loop: a case report and review of the literature. World Neurosurg. 2019;135:28-34.
Detwiler PW, Porter RW, Harrington TR, Sonntag VK, Spetzler RF. Vascular decompression of a vertebral artery loop producing cervical radiculopathy. Case report. J Neurosurg. 1998;89:485-488.
Horgan MA, Hsu FP, Frank EH. Cervical radiculopathy secondary to a tortuous vertebral artery. Case illustration. J Neurosurg. 1998;89:489-489.
Korinth MC, Mull M. Vertebral artery loop causing cervical radiculopathy. Surg Neurol. 2007;67:172-173.
Wang DD, Burkhardt J-K, Magill ST, Lawton MT. Anterior transposition of anomalous tortuous vertebral artery causing cervical radiculopathy: a report of 2 cases and review of literature. World Neurosurg. 2017;101:289-295.
Sivaraju L, Mani S, Prabhu K, Daniel RT, Chacko AG. Three-dimensional computed tomography angiographic study of the vertebral artery in patients with congenital craniovertebral junction anomalies. Eur Spine J. 2017;26:1028-1038.
Doweidar A, Al-Sayed S, Al-Kandery S. Symptomatic vertebral artery loop: a case report and review of literature. J Radiol Case Rep. 2014;8:35-41.
Kricun R, Levitt LP, Winn HR. Tortuous vertebral artery shown by MR and CT. Am J Roentgenol. 1992;159:613-615.