Cervical Foraminal Changes in Patients with Intermittent Arm Radiculopathy Studied with a New MRI-Compatible Compression Device

John Hutchins; Hanna Hebelka; Pär-Arne Svensson; Tor Åge Myklebust; Kerstin Lagerstrand; Helena Brisby

doi:10.3390/jcm12206493

Cervical Foraminal Changes in Patients with Intermittent Arm Radiculopathy Studied with a New MRI-Compatible Compression Device

J Clin Med. 2023 Oct 12;12(20):6493. doi: 10.3390/jcm12206493.

Authors

John Hutchins^{1

2}, Hanna Hebelka^{1

3}, Pär-Arne Svensson^{1

3}, Tor Åge Myklebust⁴, Kerstin Lagerstrand^{1

5}, Helena Brisby^{1

2}

Affiliations

¹ Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, SE413 45 Gothenburg, Sweden.
² Department of Orthopaedics, Sahlgrenska University Hospital, SE413 45 Gothenburg, Sweden.
³ Department of Radiology, Sahlgrenska University Hospital, SE413 45 Gothenburg, Sweden.
⁴ Department of Registration, Cancer Registry Norway, 0379 Oslo, Norway.
⁵ Department of Medical Physics and Biomedical Engineering, Sahlgrenska University Hospital, SE413 45 Gothenburg, Sweden.

Abstract

Diagnosing cervical foraminal stenosis with intermittent arm radiculopathy is challenging due to discrepancies between MRI findings and symptoms. This can be attributed to the fact that MRI images are often obtained in a relaxed supine position. This study aims to evaluate the feasibility of the Dynamic MRI Compression System (DMRICS) and to assess possible changes in cervical foramina, with both quantitative measurements and qualitative grading systems, with MRI during a simulated Spurling test. Ten patients (five women and five men, ages 29-45) with previously confirmed cervical foraminal stenosis underwent MRI scans using DMRICS. MRI images were acquired in both relaxed and provoked states. A radiologist assessed 30 foramina (C4-C7) on the symptomatic side in both patient positions. Quantitative and qualitative measures were performed, including the numeric rating scale (NRS) and the Park and Kim grading systems. The provoked state induced concordant neck and arm pain in 9 of 10 patients. Significant shifts in Park and Kim foraminal gradings were noted: 13 of 27 Park gradings and 9 of 27 Kim gradings escalated post provocation. No quantitative changes were observed. This pilot study indicates that the DMRICS device has the potential to improve diagnostic accuracy for cervical radiculopathy, demonstrating induced cervical foraminal changes during a simulated Spurling test while performing MRI.

Keywords: cervical spine; dynamic MRI; foraminal stenosis; kinetic MRI; spurling test.

Grants and funding

The study was financed by grants from the Swedish state under the agreement between the Swedish government and the county councils, the ALF-agreement grant number ALFGBG-965910 (H.B.), ALFGBG-965449 (K.L.), ALFGBG-965176 (H.H.). AFA Insurance Foundation Sweden and from King Gustav V’s and Queen Victoria’s Freemason Foundation (H.B.). Doctor Felix Neubergh Foundation (H.H.). The funders had no role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript.