Root compression on MRI compared to clinical findings in patients with recent onset cervical radiculopathy

Barbara Kuijper (1) , Jos Th.J. Tans (2) , Bas F van Der Kallen (2) , Frans Nollet (3) , Geert J Lycklama a Nijeholt (2) , Marianne de Visser (2)

1 Maasstad Ziekenhuis = Maasstad Hospital
2 Medical Center Haaglanden
3 AMC - Academic Medical Center - Academisch Medisch Centrum [Amsterdam]

Abstract Objectives To evaluate occurrence of symptomatic and asymptomatic root compression caused by herniated discs and spondylotic foraminal stenosis by magnetic resonance imaging (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 We determined the clinically suspected level of root compression in each patient. Two neuroradiologists independently evaluated MRI's, blinded for the clinical findings. For each patient the level of root compression on MRI was compared with the clinically affected level. We also examined the cause of compression: herniated disc, spondylotic foraminal stenosis or both. Results In 73 percent of patients the clinically affected root was compressed on MRI. In 45 percent MRI showed root compression without clinical substrate together with, or to a lesser extent without, the coexistence of compression of the clinically affected root. MRI's were assessed as normal in 13-15 percent of cases and in 9-10 percent 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 MRI's occur rather frequently.

Mots clés: MRI; PERIPHERAL NEUROPATHOLOGY

Barbara Kuijper, Jos Th.J. Tans, Bas F van Der Kallen, Frans Nollet, Geert J Lycklama a Nijeholt, et al.. Root compression on MRI compared to clinical findings in patients with recent onset cervical radiculopathy. Journal of Neurology, Neurosurgery and Psychiatry, 2010, 82 (5), pp.561. ⟨10.1136/jnnp.2010.217182⟩. ⟨hal-00589970⟩