Article Text

PDF
Root compression on MRI compared with clinical findings in patients with recent onset cervical radiculopathy
  1. Barbara Kuijper1,2,
  2. Jos Th J Tans1,
  3. Bas F van der Kallen3,
  4. Frans Nollet4,
  5. Geert J Lycklama a Nijeholt3,
  6. Marianne de Visser5
  1. 1Department of Neurology, Medical Centre Haaglanden, The Hague, The Netherlands
  2. 2Department of Neurology, Maasstad Hospital, Rotterdam, The Netherlands
  3. 3Department of Radiology, Medical Centre Haaglanden, The Hague, The Netherlands
  4. 4Department of Rehabilitation, Academic Medical Centre, Amsterdam, The Netherlands
  5. 5Department of Neurology, Academic Medical Centre, Amsterdam, The Netherlands
  1. Correspondence to Dr Barbara Kuijper, Maasstad Hospital, Department of Neurology, PO Box 9119, 3078 HT Rotterdam, The Netherlands; kuijperb{at}maasstadziekenhuis.nl

Abstract

Objectives To evaluate the occurrence of symptomatic and asymptomatic root compression caused by herniated discs and spondylotic foraminal stenosis by MRI in patients with recent onset cervical radiculopathy.

Participants 78 patients with symptoms and signs of cervical radiculopathy of less than one month's duration.

Methods The authors determined the clinically suspected level of root compression in each patient. Two neuroradiologists independently evaluated MRIs, blinded for the clinical findings. For each patient, the level of root compression on MRI was compared with the clinically affected level. The authors also examined the cause of compression: herniated disc, spondylotic foraminal stenosis or both.

Results In 73% of patients, the clinically affected root was compressed on MRI. In 45%, MRI showed root compression without clinical substrate together with, or to a lesser extent without, the coexistence of compression of the clinically affected root. MRIs were assessed as normal in 13–15% of cases, and in 9–10% only asymptomatic roots were compressed. Herniated discs without spondylosis were more often responsible for root compressions only at the clinically affected level and spondylotic foraminal stenosis for multiple root compression including compression of clinically unaffected roots.

Conclusion MRI findings in patients with cervical radiculopathy should be interpreted together with the clinical findings, as false-positive and false-negative MRIs occur rather frequently.

  • Cervical radiculopathy
  • MRI
  • disc herniation
  • spondylotic foraminal stenosis
  • peripheral neuropathology

Statistics from Altmetric.com

Footnotes

  • Competing interests None.

  • Patient consent Obtained.

  • Ethics approval Ethics approval was provided by the Medical Ethical Committee of Medical Centre Haaglanden.

  • Provenance and peer review Not commissioned; externally peer reviewed.

Request permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.