Suitability of Cervical Oblique Magnetic Resonance Imaging for Surgical Planning

Abstract

Objective: 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. Methods: Two hundred eighty-nine patients, who underwent 1-or 2-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 2 groups, with or without cervical oblique MRI. We attempted to determine the diagnostic power of cervical oblique MRI by evaluating PPV in specific cases. Results: The 2 groups were not significantly different in age, sex, operation time, preoperative visual analog scale (VAS), postoperative VAS. If we set diff-VAS (preoperative minus postoperative VAS) as ≥1, PPV of cervical oblique MRI was 86.76%, whereas PPV of conventional MRI was 72.35%. Each calculated PPV was higher with cervical oblique MRI. Furthermore, we identified 11 patients (8.09%) 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. Conclusion: 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.