A New Parameter, the Smallest Oblique Sagittal Area of the Neural Foramen, as an Index to Diagnose Cervical Neural Foramen Stenosis.

Abstract

OBJECTIVE:

The objective was to reconstruct the cervical neural foramen and accurately measure the minimum oblique sagittal area of the neural foramen. Then, a quantitative diagnostic standard for cervical neural foramen stenosis was proposed and its value as an indication for surgery was evaluated.

METHODS:

(1) CT data were used to reconstruct the neural foramen using Mimics software, and the minimum area was measured. (2) The optimal cut-off value was determined using a receiver operating characteristic (ROC) curve. (3) Patients who underwent single-segment surgery were divided into 2 groups according to the cut-off value. Then the postoperative neurological function improvement rate was analyzed to identify any significant difference between the 2 groups.

RESULTS:

A total of 1056 neural foramens were measured in 132 patients, of which 495 (46.88%) were diagnosed as radiculopathy by clinical neurological examination. The optimal cut-off value determined by the ROC curve was 25.95 mm2 (sensitivity 74.1%, specificity 80.9%) and the area under the curve (AUC) was 0.827 (95%CI: 0.803-0.849). There was a significant difference in the neurological function improvement rate between the 2 groups after surgery (P < 0.05). The intraclass correlation coefficient (ICC) was 0.969.

CONCLUSION:

Three-dimensional digital simulation reconstruction of CT data is a good measurement method. The optimal cut-off value determined here not only has a certain reference value for the diagnosis of cervical neural foramen bony stenosis, but also helps to select patients suitable for neural foramen decompression and can be used as a reference for surgical indication.

• Authors: Yukun Jia, Zhan Peng, Jin Li, Guangye Wang
• Journal: Canadian Association of Radiologists journal = Journal l'Association canadienne des radiologistes (Can Assoc Radiol J) Vol. 73 Issue 1 Pg. 170-178 (Feb 2022) ISSN: 1488-2361 [Electronic] United States
• PMID: 33872074 (Publication Type: Journal Article)

Topics

• Adult
• Aged
• Aged, 80 and over
• Female
• Humans
• Imaging, Three-Dimensional (methods)
• Male
• Middle Aged
• Radiculopathy (complications, diagnostic imaging)
• Radiographic Image Interpretation, Computer-Assisted (methods)
• Reproducibility of Results
• Sensitivity and Specificity
• Spinal Canal (diagnostic imaging)
• Spinal Stenosis (complications, diagnostic imaging)
• Tomography, X-Ray Computed (methods)
• Young Adult