Radiological cervical foraminal stenosis severity and morphology as a predictor of pre-operative function and functional surgical outcome

• Published in: British journal of neurosurgery 2024-07, p.1-9
• Main Authors: Meacock, James, Smedley, Alex, Sinha, Priyank, Igra, Mark, Macmullen-Price, Jeremy, Jayne, David, Stocken, Deborah, Currie, Stuart, Thomson, Simon
• Format: Article
• Language: English
• ISSN: 0268-8697; 1360-046X; 1360-046X
• DOI: 10.1080/02688697.2024.2376647

Cervical foraminal stenosis on MRI may be assessed using the Kim, modified Kim or Siller methods. This study aimed to investigate which morphological features of cervical foraminal stenosis in patients with cervical radiculopathy correlated best with pre-operative and post-operative surgical outcome following Anterior Cervical Discectomy (ACD) or a Posterior Cervical Foraminotomy (PCF). Pre-operative MRIs of adults with cervical radiculopathy were assessed by six raters. The following measurements were made; uncompressed nerve root diameter, maximal compressed nerve root diameter, anterior & posterior compression, length of the neuroforaminal canal where the diameter was less than the uncompressed nerve root diameter and the distance of maximum compression from the apex of the ligamentum flavum. The Kim, modified Kim and Siller grades were calculated. Neck Disability Index (NDI) was measured pre-operatively and six weeks post-operatively. The radiological measurements and grades were compared to the pre-operative and change in NDI. Mean NDI was higher in female (58.2) than male patients (45.6)  = 0.05. No other baseline, operative or radiological factors where significantly associated with the pre-operative NDI. The mean [±SD] post-operative NDI was 14.3 [±22.5]. This represents a change of 37.8 (