PT  - JOURNAL ARTICLE
AU  - SCHROEDER, GREGORY D.
AU  - SULEIMAN, LINDA I.
AU  - CHIOFFE, MICHAEL A.
AU  - MANGAN, JOHN J.
AU  - MCKENZIE, JAMES C.
AU  - KEPLER, CHRISTOPHER K.
AU  - KURD, MARK F.
AU  - VACCARO, ALEXANDER R.
AU  - SAVAGE, JASON W.
AU  - HSU, WELLINGTON K.
AU  - PATEL, ALPESH A.
TI  - The Effect of Oblique Magnetic Resonance Imaging on Surgical Decision Making for Patients Undergoing an Anterior Cervical Discectomy and Fusion for Cervical Radiculopathy
AID  - 10.14444/6041
DP  - 2019 Jun 01
TA  - International Journal of Spine Surgery
PG  - 302--307
VI  - 13
IP  - 3
4099  - https://www.ijssurgery.com/content/13/3/302.short
4100  - https://www.ijssurgery.com/content/13/3/302.full
SO  - Int J Spine Surg2019 Jun 01; 13
AB  - Background: The purpose of this study was to determine if oblique magnetic resonance imaging (MRI) sequences affect the surgical treatment recommendations for patients with cervical radiculopathy.Methods: In this cohort study consecutive clinical cases of persistent cervical radiculopathy requiring surgical intervention were randomized, blinded, and reviewed by 6 surgeons. Initially each surgeon recommended treatment based on the history, physical examination, and axial, coronal and sagittal preoperative magnetic resonance (MR) images; when reviewing the cases the second time, the surgeons were provided oblique MR images. This entire process was then repeated after 2 months. Change in surgical recommendation, interobserver and intraobserver reliability and the average number of levels fused was determined.Results: The addition of the oblique images resulted in the surgical recommendation being altered in 49.2% (59/120) of cases; however, the addition of oblique images did not substantially improve the interobserver reliability of the treatment recommendation (κ = .57 versus.57). Similarly, the overall intraobserver reliability using only traditional MRI sequences (κ = .64) was only slightly improved by the addition of oblique images (κ = .66). Lastly, the addition of oblique images did not change the average number of levels fused (traditional MRI = 1.38, oblique MRI = 1.41, P = .53), or the total number of 3-level fusions recommended (6 versus 6, P = 1.00)Conclusions: The additional oblique images resulted in a change to the surgical plan in almost 50% of cases; however, it had no substantial effect on the reliability of surgical decision making. Further studies are needed to see if this alteration in treatment affects clinical outcomes.Level of Evidence: 3