RT Journal Article
SR Electronic
T1 The Effect of Oblique Magnetic Resonance Imaging on Surgical Decision Making for Patients Undergoing an Anterior Cervical Discectomy and Fusion for Cervical Radiculopathy
JF International Journal of Spine Surgery
JO Int J Spine Surg
FD International Society for the Advancement of Spine Surgery
SP 302
OP 307
DO 10.14444/6041
VO 13
IS 3
A1 GREGORY D. SCHROEDER
A1 LINDA I. SULEIMAN
A1 MICHAEL A. CHIOFFE
A1 JOHN J. MANGAN
A1 JAMES C. MCKENZIE
A1 CHRISTOPHER K. KEPLER
A1 MARK F. KURD
A1 ALEXANDER R. VACCARO
A1 JASON W. SAVAGE
A1 WELLINGTON K. HSU
A1 ALPESH A. PATEL
YR 2019
UL http://ijssurgery.com//content/13/3/302.abstract
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