Vertebral Artery Insufficiency Produced by Cervical Osteoarthritic Spurs

THE SYNDROME of vertebral artery insufficiency produced by an intraluminal atheroma, a vessel redundancy, or extraluminal obstruction at or near the origin of the vertebral artery is well documented. Occlusion of the cervical vertebral artery, capable of producing symptoms and signs of cerebral vascular insufficiency, in its bony canal through the transverse processes of the cervical vertebrae, has not received its proper surgical attention. We have previously reported one such case of vertebral artery insufficiency produced by cervical osteoarthritic spurs treated surgically with reversal of neurologic symptoms.¹We are reporting an additional 15 unselected consecutive operated cases. Arteriography The method of Seldinger²was used for a complete study of the aortic arch and the extra- and intracranial vessels. The transfemoral retrograde route was usually selected if there was no arteriosclerotic impairment of distal vessel flow. Otherwise, a transbrachial or axillary percutaneous route was used. Rotational views of the cervical vessels