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J Manipulative Physiol Ther. 2000 Jan;23(1):48-51.

Tortuosity of the vertebral artery resulting in vertebral erosion.

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1
Logan College of Chiropractic, Department of Radiology, Chesterfield, MO 63006-1065, USA.

Abstract

OBJECTIVE:

To discuss the case of a patient with unilateral vertebral artery tortuosity and dilatation resulting in vertebral body and transverse foramen erosion. An emphasis is placed on diagnostic imaging.

CLINICAL FEATURES:

A 45-year-old man had a frozen shoulder and headaches. Previous arm pain, numbness, and a cold extremity were the result of occlusion of the subclavian artery and had been treated with a subclavian-carotid bypass procedure.

INTERVENTION AND OUTCOME:

As a result of the angiographic detection of the left vertebral artery dilatation and tortuosity and the concomitant hypoplastic right vertebral artery, high-velocity, low-amplitude manipulation of the cervical spine was contraindicated. However, the patient's symptoms were not related to these findings. Alternatively, low-force manipulation of the cervical spine, shoulder range of motion and muscle techniques were used, and the patient's symptoms diminished significantly with improved shoulder range of motion.

CONCLUSION:

Clinicians need to be alert to clinical presentations and appropriate imaging protocols in cases of suggested vertebral artery anomaly.

PMID:
10658876
[Indexed for MEDLINE]

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