Search Results (2)

Background: Cervical foraminal bony stenosis (CFBS) is a common degenerative spinal condition that causes radicular pain and functional impairment in the upper extremities. Accurate and objective diagnosis of CFBS remains challenging due to the absence of standardized morphometric criteria. This study aimed to determine an optimal cut-off value for the cervical foraminal cross-sectional area (CFCSA) at the C5/6 level as a diagnostic indicator of CFBS. Methods: We conducted a retrospective case-control study including 154 patients aged 50 years or older with clinically and radiologically confirmed CFBS and 150 age-matched asymptomatic controls. Cervical spine magnetic resonance imaging (MRI) was performed in all subjects and CFCSA measurements were obtained from sagittal T2-weighted images using a standardized protocol. Group differences were analyzed using t-tests and diagnostic performance was assessed using receiver operating characteristic (ROC) curve analysis. Results: The mean CFCSA was significantly lower in the CFBS group (25.65 ± 7.19 mm²) compared to the control group (43.00 ± 8.38 mm²; p < 0.001). ROC analysis identified a CFCSA threshold of 33.02 mm² as the optimal cut-off point for predicting CFBS, yielding a sensitivity of 86.4%, a specificity of 86.7%, and an area under the curve (AUC) of 0.94 (95% CI: 0.91–0.96). Conclusions: These findings suggest that CFCSA is a robust and reproducible morphological parameter for evaluating foraminal stenosis. The proposed cut-off may enhance diagnostic accuracy and aid in clinical decision-making for patients presenting with C6 radiculopathy. However, given this study’s retrospective, single-center design, further validation through multicenter, prospective studies across multiple cervical levels is warranted. Full article

Background and Objectives: Posterior cervical foraminotomy (PCF) aims to resolve cervical radiculopathy while preserving range of motion (ROM). However, its effectiveness in maintaining ROM is uncertain. This study investigates the changes in ROM after PCF and identifies preoperative factors that influence ROM reduction post surgery. Materials and Methods: This retrospective cohort study included patients treated at our hospital from August 2016 to September 2021. Clinical outcomes were assessed using the visual analog scale (VAS) for neck and arm pain and the neck disability index (NDI). Radiological outcomes included the segmental angle (SA), cervical angle (CA), C2–C7 SVA, Pfirrmann grade, extent of facetectomy, foraminal stenosis, and ROM. Patients were categorized into two groups based on segmental ROM changes: decreased (Group D) and maintained (Group M). Radiological and clinical outcomes were compared between the groups. Univariate and multivariate regression analyses were performed to identify risk factors for ROM loss after PCF. Results: 76 patients were included: 34 in Group D and 42 in Group M, with no demographic differences. Preoperatively, Group D had significantly larger flexion segmental and cervical angles than Group M (segmental, p < 0.001; cervical, p = 0.001). Group D also had a higher Pfirrmann grade (p = 0.014) and more bony bridge formations (p = 0.004). While no significant differences were observed in arm pain VAS and NDI scores, Group D exhibited worse neck pain VAS at the last follow-up (p = 0.03). Univariate linear regression indicated that preoperative segmental ROM (p < 0.001, B = 0.82) and bony bridge formation (p = 0.046, B = 5.33) were significant predictors of ROM loss post PCF. Conclusions: Patients with higher preoperative flexion angles and Pfirrmann grades at the operative level are at an increased risk for ROM loss and neck pain and often exhibit bony bridge formation. Accounting for these factors can improve surgical planning and patient outcomes. Full article