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MRI Assessment of Cervical Foraminal Stenosis Can Predict Response to Nerve Root Injection 2012

General Spine

Lubdha, Shah, MD
Erica, Bisson, MD, Non ASSR Member
Wilson, Ray, MD, Non ASSR Member

Paper/Non-Mentor

Purpose

To analyze whether cervical neuroforaminal area measured on magnetic resonance imaging (MRI) can be used to predict immediate therapeutic responses to cervical nerve root injections in patients with cervical radiculopathy.

Methods & Materials

A retrospective chart review identified 64 consecutive patients treated at a single tertiary referral center. Data collected included patient demographics, neuroforaminal area of the symptomatic and contralateral side, Visual Analog Score pre- and post-injection, history of previous cervical surgery, comorbidities, and history of tobacco use.

Results

Sixty-four consecutive patients with symptoms of cervical radiculopathy were treated with neuroforaminal nerve root injections were identified. The average foraminal area of the symptomatic side was significantly smaller than the contralateral asymptomatic neuroforamen(p<0.0001). Diabetes and tobacco use did influence patient response to treatment.

Conclusion

Measurement of neuroforaminal areas may represent a useful pre-procedural technique to predict which patients with symptoms of cervical radiculopathy secondary to foraminal stenosis are likely to respond to selective nerve root injections. It is limited to only those patients with severe stenosis and was less useful in those patients with moderate or mild stenosis. Larger prospective studies are needed to verify these retrospective results and make more meaningful conclusions regarding other demographic predictors.