Vertebral artery stenosis from osteophyte: A systematic review and case series

IF 1.5 4区医学 Q4 CLINICAL NEUROLOGY Neurochirurgie Pub Date : 2024-01-29 DOI:10.1016/j.neuchi.2023.101525

Davaine Joel Ndongo Sonfack , Michel Wieslaw Bojanowski , Bilal Tarabay , Antoine Gennari , Daniel Shédid , Sung-Joo Yuh

{"title":"Vertebral artery stenosis from osteophyte: A systematic review and case series","authors":"Davaine Joel Ndongo Sonfack , Michel Wieslaw Bojanowski , Bilal Tarabay , Antoine Gennari , Daniel Shédid , Sung-Joo Yuh","doi":"10.1016/j.neuchi.2023.101525","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><p>Rotational vertebral artery syndrome, also referred to as Bow Hunter’s syndrome (BHS), manifests when the vertebral artery (VA) is compressed following head rotation. This compression is often caused by an osteophyte and may lead to symptoms of a posterior stroke. This systematic review aims to shed light on the current management strategies for BHS resulting from osteophytes. Additionally, we present two illustrative cases where the VA compression by an osteophyte was effectively resolved by complete resection of the problematic bone spur.</p></div><div><h3>Methods</h3><p>A literature search was conducted across Embase, PubMed and Medline in September 2023. Keywords related to vertebral artery [MESH], vertebrobasilar insufficiency [MESH] and osteophyte [MESH] were the focus of this review. Risk of bias in retained studies was assessed using the Joanna Briggs Institute Critical Appraisal tools for Qualitative Research. A narrative synthesis of our findings is presented.</p></div><div><h3>Results</h3><p>A total of 30 studies were included in this review. Vertigo was the most reported symptom by patients (n = 16). On imaging, the VA was often compressed at C4−5 (n = 10) and C5−6 (n = 10) with no evident side predominance observed. Anterior cervical discectomy and fusion (ACDF, n = 13) followed by anterior decompression without fusion (n = 8) were the most performed surgical procedures to manage BHS.</p></div><div><h3>Conclusion</h3><p>Surgical decompression of the VA is a safe and effective intervention for patients experiencing symptomatic osteophytic compression during head rotation. This procedure restores normal vascular function and reduces the risk of ischemic events. This review highlights the importance of timely diagnosis and intervention in such cases.</p></div>","PeriodicalId":51141,"journal":{"name":"Neurochirurgie","volume":"70 3","pages":"Article 101525"},"PeriodicalIF":1.5000,"publicationDate":"2024-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Neurochirurgie","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0028377023001236","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}

引用次数: 0

Abstract

Background

Rotational vertebral artery syndrome, also referred to as Bow Hunter’s syndrome (BHS), manifests when the vertebral artery (VA) is compressed following head rotation. This compression is often caused by an osteophyte and may lead to symptoms of a posterior stroke. This systematic review aims to shed light on the current management strategies for BHS resulting from osteophytes. Additionally, we present two illustrative cases where the VA compression by an osteophyte was effectively resolved by complete resection of the problematic bone spur.

Methods

A literature search was conducted across Embase, PubMed and Medline in September 2023. Keywords related to vertebral artery [MESH], vertebrobasilar insufficiency [MESH] and osteophyte [MESH] were the focus of this review. Risk of bias in retained studies was assessed using the Joanna Briggs Institute Critical Appraisal tools for Qualitative Research. A narrative synthesis of our findings is presented.

Results

A total of 30 studies were included in this review. Vertigo was the most reported symptom by patients (n = 16). On imaging, the VA was often compressed at C4−5 (n = 10) and C5−6 (n = 10) with no evident side predominance observed. Anterior cervical discectomy and fusion (ACDF, n = 13) followed by anterior decompression without fusion (n = 8) were the most performed surgical procedures to manage BHS.

Conclusion

Surgical decompression of the VA is a safe and effective intervention for patients experiencing symptomatic osteophytic compression during head rotation. This procedure restores normal vascular function and reduces the risk of ischemic events. This review highlights the importance of timely diagnosis and intervention in such cases.

查看原文

微信好友朋友圈 QQ好友复制链接

本刊更多论文

骨质增生引起的椎动脉狭窄：系统回顾与病例系列。

背景：旋转性椎动脉综合征又称鲍-亨特综合征（BHS），表现为头部旋转后椎动脉（VA）受到压迫。这种压迫通常是由骨质增生引起的，可能导致后中风症状。本系统综述旨在阐明目前针对骨质增生引起的 BHS 的治疗策略。此外，我们还介绍了两个典型病例，通过完全切除问题骨刺，有效解决了骨质增生对 VA 的压迫：方法：我们于 2023 年 9 月在 Embase、PubMed 和 Medline 上进行了文献检索。与椎动脉[MESH]、椎基底动脉供血不足[MESH]和骨质增生[MESH]相关的关键词是本次综述的重点。采用乔安娜-布里格斯研究所（Joanna Briggs Institute）的定性研究批判性评估工具对保留研究的偏倚风险进行了评估。本文对研究结果进行了叙述性综述：本综述共纳入了 30 项研究。眩晕是患者报告最多的症状（n = 16）。在影像学检查中，C4-5（10 人）和 C5-6（10 人）处的 VA 常常受到压迫，但未观察到明显的一侧优势。前路颈椎椎间盘切除和融合术（ACDF，n = 13）和前路减压术（n = 8）是治疗BHS最多的手术方法：结论：对于在头部旋转过程中出现症状性骨质增生压迫的患者来说，对VA进行手术减压是一种安全有效的干预措施。该手术可恢复正常的血管功能，降低缺血性事件的风险。本综述强调了在此类病例中及时诊断和干预的重要性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文去求助

来源期刊

Neurochirurgie 医学-临床神经学

CiteScore

2.70

自引率

6.20%

发文量

100

审稿时长

29 days

期刊介绍： Neurochirurgie publishes articles on treatment, teaching and research, neurosurgery training and the professional aspects of our discipline, and also the history and progress of neurosurgery. It focuses on pathologies of the head, spine and central and peripheral nervous systems and their vascularization. All aspects of the specialty are dealt with: trauma, tumor, degenerative disease, infection, vascular pathology, and radiosurgery, and pediatrics. Transversal studies are also welcome: neuroanatomy, neurophysiology, neurology, neuropediatrics, psychiatry, neuropsychology, physical medicine and neurologic rehabilitation, neuro-anesthesia, neurologic intensive care, neuroradiology, functional exploration, neuropathology, neuro-ophthalmology, otoneurology, maxillofacial surgery, neuro-endocrinology and spine surgery. Technical and methodological aspects are also taken onboard: diagnostic and therapeutic techniques, methods for assessing results, epidemiology, surgical, interventional and radiological techniques, simulations and pathophysiological hypotheses, and educational tools. The editorial board may refuse submissions that fail to meet the journal''s aims and scope; such studies will not be peer-reviewed, and the editor in chief will promptly inform the corresponding author, so as not to delay submission to a more suitable journal. With a view to attracting an international audience of both readers and writers, Neurochirurgie especially welcomes articles in English, and gives priority to original studies. Other kinds of article - reviews, case reports, technical notes and meta-analyses - are equally published. Every year, a special edition is dedicated to the topic selected by the French Society of Neurosurgery for its annual report.