The long-term follow-up of surgical treatment for cervical myelopathy with severe nape and upper arm pain caused by the anomalous vertebral artery - Case report

Study Design. A case of cervical myelopathy with a severe nape and upper arm pain caused by anomalous bilateral vertebral arteries is reported. Objective. To report over six and a half years results of a microsurgical decompression for high cervical myelopathy with a severe pain of nape and upper arm resulting from spinal cord compression by the anomalous vertebral arteries. Summary of Background Data. Although symptomatic cases of anomalies of vertebral artery (VA), such as fenestration or elongation, leading to severe cervical pain, cervical myelopathy, or accessory nerve palsy have been reported, no long-term results of microsurgical decompression for those cases have been reported. Methods. The clinical features of the case and over 61/2 years results of microsurgical decompression by retracting the arteries with silicon tapes and a dural patch are reported. An etiology and the treatment of the cases are discussed with a review of the previous documented cases. Results. The cord compression was relieved surgically, and the patient's symptoms have improved after surgery throughout the follow-up period. Conclusion. Anomalous vertebral arteries should be included in the differential diagnosis of the upper cervical lesion of unknown origin. The microsurgical decompression with presented technique has relieved the symptoms for over 61/2 years.