Interreader Reliability and Clinical Validity of a Magnetic Resonance Imaging Grading System for Cervical Foraminal Stenosis

Abstract

Regardless of reader experience, there was substantial to almost perfect interreader reliability with the Park system for CNFS based on oblique sagittal MRI.

<p>Best cut-off point of the cervical facet joint area as a new morphological measurement tool to predict cervical foraminal stenosis</p>

“…Significant narrowing of the cervical foramen may present as a sharp arm or neck pain, paresthesia, numbness or tingling sensation with or without symptoms spreading to the distal portion of the upper extremities 2,5. In order to exclude the possibility of other diseases and to determine appropriate treatment, an accurate CMRI diagnosis of CFS is essential 3,16. CFS is caused by the compression of the cervical nerve roots, commonly a result of lateral disc herniation or degenerative osteophytes 17–19.…”

“…Motor symptoms such as weakness may sometimes accompany sensory symptoms in aggravated narrowing 5–7. Cervical spine magnetic resonance imaging (CMRI) is the most sensitive technique for detecting early morphological changes in the cervical spine 3,8. An accurate CMRI diagnosis of CFS is critical to determine appropriate treatment and to exclude the possibility of peripheral neuropathy 3,9.…”

“…Cervical spine magnetic resonance imaging (CMRI) is the most sensitive technique for detecting early morphological changes in the cervical spine 3,8. An accurate CMRI diagnosis of CFS is critical to determine appropriate treatment and to exclude the possibility of peripheral neuropathy 3,9. Clinical care of patients with CFS is determined based on neurological symptoms with CMRI studies 5.…”

Investigating whether advanced MR imaging can be used to demonstrate trapped nerves in healthy volunteers

“…However, despite MRI providing excellent non-invasive imaging of the spine its use as a tool to assess foraminal stenosis could be improved. The site and length of nerve root compression varies from patient to patient and visualisation of the compressed nerve root will be affected by the MRI protocol including the imaging sequence and the plane used (Lee et al, 2017). Cervical root canal stenosis is usually reported using subjective terms such as "minor", "moderate" and "severe".…”

“…Lee et al (2017) compared the Park, Kim and modified Kim systems in their ability to correlate with clinical symptoms. The Park and Modified Kim systems had high correlation coefficients whereas the unmodified Kim system had moderate correlation only.…”