Cervical Arthroplasty in the Treatment of Cervical Angina: Case Report and Review of the Literature

Omar M. Al Jammal; Luis Daniel Daz-Aguilar; Shanmukha Srinivas; Jillian Plonsker; Ronald Sahyouni; Martin H. Pham

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자료유형: 학술저널

저자정보: Omar M. Al Jammal (Department of Neurosurgery University of California San Diego School of Medicine) Luis Daniel Daz-Aguilar (Department of Neurosurgery University of California San Diego School of Medicine) Shanmukha Srinivas (Department of Neurosurgery University of California San Diego School of Medicine) Jillian Plonsker (Department of Neurosurgery University of California San Diego School of Medicine) Ronald Sahyouni (Department of Neurosurgery University of California San Diego School of Medicine) Martin H. Pham (Department of Neurosurgery University of California San Diego School of Medicine)

저널정보: 대한척추신경외과학회 Neurospine 대한척추신경외과학회지 제17권 제4호

발행연도: 2020.1

수록면: 929 - 938 (10page)

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Cervical angina is an often-overlooked etiology of noncardiac chest pain that may mimic true angina pectoris but is due to cervical spine disease. Diagnosis can be difficult, and treatment ranges from conservative therapy to surgical management. However, of patient’s refractory to conservative therapy, approximately ninety percent experience postoperative relief of angina symptoms. Here, we present a case report on cervical angina and performed a systematic review of the literature. A 34-year-old male with prior surgery for thoracic outlet syndrome presented with persistent anterior neck and chest pain as well as posterior left scapular and upper lateral arm pain. The pain was refractory to 12 months of conservative therapy. Cardiac workup was negative and cervical spine imaging revealed a C6–7 herniation with neuroforaminal stenosis. A systematic literature search was conducted in PubMed, Web of Science, and Cochrane databases from database inception to April 2020. Studies reporting cervical level, average symptom duration, location of pain, and postoperative pain improvement were included. The patient's atypical symptoms were completely resolved after C6–7 anterior cervical discectomy and arthroplasty. To our knowledge, this is the first study which reports on the use of arthroplasty in the treatment of cervical angina. The systematic review included 11 articles from 1989–2020 consisting of 1,186 total patients and 109 patients (age range, 36–84 years; 60.7% male) meeting inclusion criteria. Symptom duration range was 2 days to 90 months, with the most common location of pain being localized to the anterior chest wall (66.7% of patients). All patients (100%) had postoperative resolution of their pain symptoms. The most common herniation level was C6–7 (87.3% of patients). We conclude that a broad and multidisciplinary approach is necessary for the diagnosis and management of noncardiac chest pain. When cervical disease is identified as the underlying cause for the angina-like pain, conservative therapy should be sought. Refractory cases should be treated surgically depending on the cervical pathology.

#Cervical angina #Pseudoangina #Management of cervical angina #Cervical arthroplasty #Chest pain #Cervical discectomy

참고문헌 (33)

참고문헌 신청

Brodsky AE / 1985 / Cervical angina. A correlative study with emphasis on the use of coronary arteriography / Spine 10:699~709

Jacobs B / 1990 / Cervical angina / N Y State J Med 90:8~11

Sussman WI / 2015 / Cervical angina : an overlooked source of noncardiac chest pain / Neurohospitalist 5:22~27

Wells P / 1997 / Cervical angina / Am Fam Physician 55:2262~2264

Güler N / 2000 / Acute ECG changes and chest pain induced by neck motion in patients with cervical hernia--a case report / Angiology 51:861~865

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