Significant differences were also obtained for the levels C3-4, C5-6, and C6-7. Mean neuroforaminal grades of 2.36 were obtained in SSIs compared to 2.91 in OSIs. Forty-seven percent of neuroforminal stenoses were identified by at least one radiologist as at least one grade lower in SSIs compared to OSIs. Both radiologists underestimated the neuroforminal stenosis grade (NSG) by 2 units in seven cases. 1 Grading of SSIs seemed more prone to error than the grading of OSIs, the authors found, noting that grading differed significantly between the two techniques. The exams were independently reviewed by two radiologists experienced in musculoskeletal imaging who graded neuroforminal stenosis on a four-point classification system. They identified 29 patients with 45 disc herniations that compromised the cervical neural foramen on axial T2-weighted images who received treatment at the hospital from January 2014 through June 2017. The radiologists argue that compared to OSIs, standard sagittal images tend to underestimate neuroforaminal stenosis grades, and are therefore less reliable in evaluating disc herniations in the cervical spine.įor their comparative analysis, lead author Laurent Kintzelé, MD, of the Diagnostic and Interventional Radiology Department of University Hospital Heidelberg, and colleagues hypothesized that OSIs can improve the assessment of neuroforaminal stenosis resulting from disc herniation. It supplements standard anteroposterior (AP) and lateral x-rays for patients experiencing neurological symptoms or not responding to conservative treatment.Ī cervical spine MRI should include oblique sagittal images (OSIs) in addition to standard sagittal images (SSIs), radiologists from the University Hospital Heidelberg in Germany advise in the June 2018 edition of the German medical imaging e-journal, R ö fo. Magnetic resonance imaging (MRI) plays a key role in the assessment of spinal cord and root impingement responsible for chronic neck pain.

Oblique upper cervical spine x ray