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Erschienen in:
15.05.2017 | Grand Rounds
Double crush syndrome caused by cervical spondylosis and vertebral artery loop
Erschienen in: European Spine Journal | Ausgabe 2/2019
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Purpose
The purpose of this article is to report a successful treatment experience in a rare case of simultaneous cervical nerve root compression by spondylotic cervical foraminal stenosis and a vertebral artery loop.
Methods
51-year-old man presented with a 4-year history of left-sided cervical pain radiating to the left shoulder with progressive exacerbation of weakness on left shoulder girdle muscles for 7 months. The patient had no history of trauma. The patient’s CT and MRI revealed impingement of the left C6 cervical nerve root by a tortuous vertebral artery loop and also by narrowed left C5–6 cervical foramen that had undergone spondylotic changes. The patient underwent left C5–6 hemilaminectomy, facetectomy and C5–6 fusion. The procedures were uneventful, and the patient recovered with complete resolution of symptoms.
Results
The patient continued to be asymptomatic at a 2-year follow-up examination, and the muscle mass of his left girdle returned normal.
Conclusions
This report illustrates the first phenomenon of a double crush syndrome caused by vertebral artery loop and cervical spondylotic changes. When patients with cervical spondylosis present with unexplainably severe pain and weakness, additional underlying pathologies should be considered when making differential diagnoses. The investigation planning should involve electromyography, computed tomography angiography, and magnetic resonance imaging.