Vertebral artery anomaly with entry at C4--avoiding a surgical pitfall: a case report

European Spine Journal : Official Publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society
Matthias MüllerMichael Ruf

Abstract

We present a case of an unusual course of the vertebral artery (VA) with intra-foraminal entrance at C4. A patient with traumatic fracture of C3 and C4 with dislocation C3/C4, spinal cord compression and ensuing quadriplegia presented with unilateral entrance of the VA at C4 detected on preoperative magnetic resonance imaging (MRI). The patient was surgically decompressed and stabilized by an anterior-posterior approach without intra-operative complications. Apart from anatomical findings no clinical case of entrance of the VA at C4 had been described in recent clinical literature. A physiologic high entrance of the VA is very rare but must be diagnosed preoperatively to avoid potential life threatening complications.

References

Jan 1, 1989·Acta Anatomica·S Cavdar, E Arisan
Apr 27, 2004·Clinical Anatomy : Official Journal of the American Association of Clinical Anatomists & the British Association of Clinical Anatomists·Valéria Paula Sassoli FazanOmar Andrade Rodrigues Filho
Nov 16, 2004·The Spine Journal : Official Journal of the North American Spine Society·Francis H ShenHoward S An
Nov 12, 2005·Acta Neurologica Scandinavica·J Inamasu, B H Guiot

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Citations

Jul 3, 2010·Journal of Neurosurgery. Spine·Andre TomasinoRoger Härtl
Apr 26, 2013·European Spine Journal : Official Publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society·Fadi TaherAlexander P Hughes
Jan 25, 2013·Journal of Korean Neurosurgical Society·Sung Bae ParkSang Hyung Lee
Aug 4, 2021·Case Reports in Orthopedics·Jay MoranDaniel R Rubio

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