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      Best cut-off point of the cervical facet joint area as a new morphological measurement tool to predict cervical foraminal stenosis

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          Purpose: One of the main factor of cervical foraminal stenosis (CFS) is the hypertrophic change of the cervical facet joint. In order to analyze the connection between CFS and the facet joint hypertrophy, we devised a new morphological parameter, called the cervical facet joint cross-sectional area (CFJA). The CFJA has not yet been investigated for its association with CFS. We hypothesized that the CFJA is an important morphologic parameter in the diagnosis of CFS.

          Patients and methods: All patients over 50 years of age were included. Data regarding the CFJA were collected from 160 subjects with CFS. A total of 162 control individuals underwent cervical spine magnetic resonance imaging (CMRI) as part of a routine medical examination. Axial T2-weighted CMRI images were acquired from all subjects. We used a picture archiving system to analyze the cross-sectional area of the bone margin of the cervical facet joint at the level of the most stenotic cervical spine in the axial plane.

          Results: The average CFJA was 109.07±20.91 mm 2 in the control group, and 126.75±22.59 mm 2 in the CFS group. The CFS group was found to have significantly higher levels of the CFJA ( p<0.001) than the control group. ROC curve estimation was used to verify the validity of the CFJA as a new predictor of CFS. In the CFS group, the best cut off-point was 113.14 mm 2, with sensitivity =70.6%, specificity =68.6%, and AUC =0.72 (95% CI, 0.66–0.77).

          Conclusions: CFJA high values were closely associated with a possibility of CFS. We concluded CFJA is easy to use, fast, and useful new morphological parameter to predict CFS.

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          Most cited references 29

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          Cervical radiculopathy.

          Cervical radiculopathy is the result of irritation and/or compression of nerve root as it exits the cervical spine. Pain is a common presenting symptom and may be accompanied by motor or sensory deficits in areas innervated by the affected nerve root. Diagnosis is suggested by history and corresponding physical examination findings. Confirmation is achieved with MRI. A multimodal approach to treatment helps patients improve. Medications may be used to alleviate symptoms and manage pain. Physical therapy and manipulation may improve neck discomfort. Guided corticosteroid injections and selected nerve blocks may help control nerve root pain. Most patients improve with a conservative, nonoperative treatment course.
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            Cervical radiculopathy: pathophysiology, presentation, and clinical evaluation.

            Cervical radiculopathy is a common condition that usually results from compression and inflammation of the cervical nerve root or roots in the region of the neural foramen. It is frequently caused by cervical disc herniation and cervical spondylosis. The diagnosis can be established by history and physical examination, but care should be taken, as diagnoses can mimic or coexist with cervical radiculopathy, such as entrapment neuropathies. The pathophysiology, presentation, and clinical evaluation of cervical radiculopathy are discussed.
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              A practical MRI grading system for cervical foraminal stenosis based on oblique sagittal images.

               H.-J. Park,  S S Kim,  S-Y Lee (2013)
              To propose a new and practical MRI grading method for cervical neural foraminal stenosis and to evaluate its reproducibility.

                Author and article information

                J Pain Res
                J Pain Res
                Journal of Pain Research
                24 April 2019
                : 12
                : 1325-1330
                [1 ]Department of Neurology, Catholic Kwandong University, College of Medicine, International ST. Mary’s Hospital , Incheon, Republic of Korea
                [2 ]Department of Anesthesiology and Pain Medicine, Kangdong Sacred Heart Hospital, Hallym University, College of Medicine , Seoul, Republic of Korea
                [3 ]Department of Anesthesiology and Pain Medicine, Catholic Kwandong University, College of Medicine, International ST. Mary's Hospital , Incheon, Republic of Korea
                Author notes
                Correspondence: Young Uk KimDepartment of Anesthesiology and Pain Medicine, Catholic Kwandong University, College of Medicine, International ST. Mary's Hospital , Simgokro 100Gil 25 Seo-gu, Incheon City22711, Republic of KoreaTel +82 103 243 6643Fax +8 232 290 3568Email uk201@ 123456hanmail.net
                © 2019 An et al.

                This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License ( http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms ( https://www.dovepress.com/terms.php).

                Page count
                Figures: 2, Tables: 4, References: 31, Pages: 6
                Original Research


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