Cervical radiculopathy secondary to vertebral artery dissection: clinical features and outcomes

ABSTRACT

Purpose

Cervical radiculopathy due to various mechanical causes is commonly seen, however, cervical vertebral artery dissection (cVAD)-related radiculopathy is very rare with poorly characterized clinical outcomes. Thus, we conducted a systematic review of published literature and reported an institutional case to provide a better illustration of this rare entity.

Methods

We systematically reviewed the PubMed literature and queried the clinical database at our center for cVAD-related radiculopathy. We described the baseline characteristics of patients with cVAD-related radiculopathy, the involved segment, diagnostic approach and treatment options.

Result

14 previously published studies met the inclusion criteria and along with the case we identified in our center, our study included 17 patients total (median age: 35 years, 9 females). C5 was the most commonly affected root and ipsilateral shoulder/arm pain along with shoulder abduction weakness was most common presentation. Antiplatelet or anticoagulant therapy was the treatment of choice. Most cases managed conservatively (82%). Majority of the cases (92%) had either complete or partial resolution of their symptoms.

Conclusion

Despite its limitations, this study show that cVAD related radiculopathy is a relatively benign entity with excellent clinical outcomes when managed medically.

KEYWORDS:

• Vertebral dissection
• vertebral aneurysm
• radiculopathy

Disclosure statement

No potential conflict of interest was reported by the author(s).

Authors’ contributions

Conceptualization: BB, MAE, CRH, AIC, GL, ZK, Writing – Original Draft: BB, ZK, Writing – Review & Editing: BB, MAE, CRH, AIC, GL, ZK, Supervision: AIC, GL, ZK

Consent for publication

We obtained consent for publication from the participant.

Data availability statement

Anonymized data not published within this article will be made available by request from any qualified investigator.

Ethics approval/Consent to participate

This study was reviewed and approved by the Institutional Review Board (IRB). All patients included in the study had given consent for participation in research through the Minnesota Research Authorization.

Additional information

Funding

The author(s) reported there is no funding associated with the work featured in this article.