Integrative Korean medicine treatment without surgery for the management of subacute radiating pain attributed to vertebral artery loop formation: A case report and literature review

Rationale:Vertebral artery loop formation (VALF) compresses the adjacent cervical nerve root, resulting in cervical radiculopathy at the affected level. Neurosurgical interventions for anatomical separation are typically employed to relieve the symptoms, regardless of their duration. We herein report the management of the subacute symptoms of a rare case of cervical radiculopathy attributed to VALF using integrative Korean medicine (iKM) treatment without surgery.Patient concerns:A 54-year-old male patient presenting with a chief complaint of headache radiating to the posterior cervical and right scapular regions was treated with a 4-day program of inpatient care.Diagnoses:Based on the findings of the cervical spine magnetic resonance imaging, the patient was diagnosed with VALF on the right side at the C3/C4 level.Interventions:He underwent iKM treatment comprising acupuncture, pharmacopuncture, Chuna therapy, and herbal medicine.Outcomes:Significant improvement was noted in the patient's condition (neck pain Numeric Rating Scale scores of 5, 4, and 1; Neck Disability Index scores of 35.56, 20, and 4; and EuroQol 5-dimension index scores of 0.754, 0.787, and 0.862 at admission, discharge, and the 2-month follow-up, respectively; Patient Global Impression of Change scores of 3 and 1 at discharge and the 2-month follow-up, respectively).Lessons:This case report suggests that iKM treatment may be effective for subacute VALF symptoms without requiring surgery.