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Suitability of cervical oblique magnetic resonance imaging for surgical planning
Ji Hwan Yoo, Jeong Yoon Park, DongKyu Chin, Kyung Hyun Kim, Sung Uk Kuh, Yong Eun Cho
Department of Neurosurgery, Gangnam Severance Hospital, Spine and Spinal Cord Institute, Yonsei Univ, Seoul, Korea
Correspondence  DongKyu Chin ,Tel: +082-2-2019-3397, Fax: +082-2-3461-9229, Email: dkc.spine@gmail.com
Received: June 28, 2018;  Accepted: July 30, 2018.  Published online: July 30, 2018.
Our aim was to calculate the diagnostic power, including positive predictive value (PPV), of cervical oblique magnetic resonance imaging (MRI), and to identify cases in which its use led to altered surgical plans.
Five hundred fifty-six patients, who underwent one- or two-level anterior cervical discectomy and fusion from January 2015 to December 2017, were included in this study. Medical records were reviewed. Statistical analysis was performed to assess the equality of the two groups, with or without cervical oblique MRI. We attempted to determine the diagnostic power of cervical oblique MRI by evaluating PPV in specific cases.
The two groups were not significantly different in age, sex, operation time, preoperative visual analog score (VAS), postoperative VAS, or the ratio of patients who complained of myelopathy. As immediate postoperative pain scores predict future neck pain, immediate pain relief, assessed by VAS, was recorded. If we set immediate pain relief (preoperative minus postoperative VAS) as >1, PPV of cervical oblique MRI was 79.8%, whereas PPV of conventional MRI was 73.7%. Each calculated PPV was higher with cervical oblique MRI. Furthermore, we identified 11 patients (4.33%) who experienced a change in surgical plan because of cervical oblique MRI. Measured widths of the foramen were 3.69 mm in axial images and 3.31 mm in oblique images.
Cervical oblique MRI can enable a more accurate surgical plan and facilitate patient selection for surgery. Cervical oblique MRI could be useful for additional information and to predict the immediate prognosis of patients preoperatively.
Key words: Magnetic Resonance Imaging; Predictive Value of Tests; Visual Analog Scale; Intervertebral Disc Degeneration; Radiculopathy
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Related article
Suitability of Cervical Oblique Magnetic Resonance Imaging for Surgical Planning  2018 October;4(2)
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