Cervical conjoined nerve root variant: preoperative imaging and surgical conformation. Case report

Abstract

A case of a nerve root anomaly in a patient presenting with cervical radiculopathy is presented. The patient was treated with posterolateral exploration and decompression, resulting in relief of pain and improvement in strength. Both the preoperative contrast-enhanced computerized tomography scan and the magnetic resonance image demonstrated an abnormality behind the C-4 body extending from the right C3-4 neural foramen to the neural foramen at C4-5. At surgery, a dural-encased structure was discovered connecting the C-4 and C-5 nerve roots within the spinal canal. This paper describes the first reported case of a cervical nerve root anomaly of this type, representing a variant of a conjoined nerve root. The occurrence of such nerve root anomalies in the cervical spine should be entered into the differential diagnosis and treatment of cervical radiculopathy.