J Korean Neurosurg Soc.  2014 Dec;56(6):513-516. 10.3340/jkns.2014.56.6.513.

Usefulness of Intraoperative Monitoring during Microsurgical Decompression of Cervicomedullary Compression Caused by an Anomalous Vertebral Artery

Affiliations
  • 1Department of Neurosurgery, Busan Paik Hospital, Inje University School of Medicine, Busan, Korea. 106304@paik.ac.kr

Abstract

We report a case of cervicomedullary compression by an anomalous vertebral artery treated using microsurgical decompression with intraoperative monitoring. A 68-year-old woman presented with posterior neck pain and gait disturbance. MRI revealed multiple abnormalities, including an anomalous vertebral artery that compressed the spinal cord at the cervicomedullary junction. Suboccipital craniectomy with C1 laminectomy was performed. The spinal cord was found to be compressed by the vertebral arteries, which were retracted dorsolaterally. At that time, the somatosensory evoked potential (SSEP) changed. After release of the vertebral artery, the SSEP signal normalized instantly. The vertebral artery was then lifted gently and anchored to the dura. There was no other procedural complication. The patient's symptoms improved. This case demonstrates that intraoperative monitoring may be useful for preventing procedural complications during spinal cord microsurgical decompression.

Keyword

Vertebral artery; Microvascular decompression; Cervicomedullary junction; Intraoperative monitoring

MeSH Terms

Abnormalities, Multiple
Aged
Decompression*
Evoked Potentials, Somatosensory
Female
Gait
Humans
Laminectomy
Magnetic Resonance Imaging
Microvascular Decompression Surgery
Monitoring, Intraoperative*
Neck Pain
Spinal Cord
Vertebral Artery*
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