Cervical Pedicle Erosion and Rootlet Compression Caused by a Tortuous Vertebral Artery

Plain cervical roentgenograms in a 54-year-old female with left-sided neck pain showed an enlarged C3–C4 intervertebral foramen. Cervical myelography in this area was normal. Arteriography revealed that the left vertebral artery looped into this enlarged foramen, and surgical exploration showed that the loop had severely compressed the rootlet emerging from this foramen. Foraminotomy and section of the rootlet resulted in gradual resolution of the patient's symptoms.