![]() ![]() We found that the addition of oblique sagittal CT and 3DCT images substantially changed the surgical plans of all four surgeons. Because evaluating bony foraminal stenosis is important in formulating a surgical plan, we sought to determine the utility of oblique sagittal CT and 3DCT images in identifying bony foraminal stenosis in surgical cases. However, the frequency of radiculopathy depends more on osteophytes than on disk herniation 15. CT is helpful in identifying osteophytes in the spondylotic spine, whereas MRI is helpful for identifying foraminal stenosis because of the involvement of soft tissue 12, 13, 14. However, it cannot always differentiate soft tissues from bony pathology in the foramen 11 therefore, an additional evaluation of CT images can be helpful in surgical planning. MRI is an important modality for evaluating neural compression in the cervical spine. ![]() The purpose of this study was to determine whether using oblique sagittal CT and 3DCT affects surgical plans for patients with cervical foraminal stenosis. As per our experience, determination of foraminal narrowing can often be improved 7 by several different modalities, including plain radiographs, computed tomography (CT) scans, and magnetic resonance imaging (MRI) in multiple planes.Īlthough few studies have evaluated the utility of oblique sagittal reformatted CT (oblique sagittal CT) images in assessing cervical neuroforaminal stenosis 8, 9, to the best of our knowledge, no study has reported the extent to which oblique sagittal CT and three-dimensional surface reconstruction CT (3DCT) affect the surgical plan in the cervical spine. Foramina, in particular, have complicated shapes. Occasionally, the imaging findings can be subtle and are missed without a proper plane of view. ![]() Therefore, the surgeon has to rely on a combination of symptoms, physical findings, and concordant imaging findings to determine the source of the patient’s symptoms. On the other hand, diagnoses based on imaging studies can be inaccurate because asymptomatic findings are common 4, 5, 6. The addition of oblique sagittal CT and 3DCT is helpful in evaluating the foramen and planning surgical treatment of cervical radiculopathy.ĭetermining the responsible level of cervical radiculopathy can be difficult because radicular pain does not always follow commonly used dermatomal maps 1, 2, 3. Therefore, the addition of oblique and 3DCT images improves inter-rater reliability owing to changes in a part of decompressed foramina. Consequently, we analyzed these changes in the decompressed foramina in the surgical plan mean percent change in the plan was 18.1%. After reviewing the MRI and sagittal, coronal, and axial CT images, the reviewers recorded the operation to be performed they examined oblique sagittal CT and 3DCT images of the same patients and noted any differences from their surgical plans. Accordingly, four reviewers, with office notes, observed the CT and magnetic resonance imaging (MRI) images of 18 patients undergoing surgical treatment for cervical radiculopathy. Therefore, we investigated whether the application of oblique sagittal reformatted computed tomography (oblique sagittal CT) and three-dimensional surface reconstruction CT (3DCT) affects surgical plans for patients with cervical foraminal stenosis and whether it assists diagnosis of foraminal stenosis. Because asymptomatic findings are common in cervical radiculopathy, diagnoses based on imaging studies can be inaccurate. Determining the responsible level of cervical radiculopathy can be difficult. ![]()
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