This case highlights the importance of considering multilevel, multidirectional osteophytic compression in the evaluation of BHS. To the authors' knowledge, this represents the first documented instance of BHS resulting from concurrent lateral and posterior compression at two adjacent cervical levels, emphasizing the need for comprehensive vascular and bony assessment in atypical presentations. https://thejns.org/doi/10.3171/CASE25718.
Zhu et al. (Mon,) studied this question.