Background
This study examined cervical transforaminal ligament(TFL) displays in cadavers and living bodies using magnetic resonance imaging (MRI) and evaluated the correlation between nerve entrapment in the brachial plexus by the TFL and cervical radiculopathy(CR).
Methods
First, 6 normal intact adult cervical specimens were used to calculate the relevant capacity in displaying the cervical TFLs by the three-dimensional fast imaging employing steady-state acquisition (3D-FIESTA). Second, 10 patients with CR and 10 healthy subjects were selected to perform the 3D-FIESTA sequence scan at the C4-T1 intervertebral foramina. The TFL display rate was calculated, and its correlation with CR was analysed.
Results
The microscopic anatomical results showed that the cervical TFL incidence was 39.6%. The relative capacity of the 3D-FIESTA sequence in displaying cervical TFLs showed a 96.6% specificity and a 73.7% sensitivity. In the 10 patients with CR, cervical TFLs were present in 17 intervertebral foramina, of which, 10 cases showed hypertrophy of the TFLs causing nerve entrapment, and corresponding symptoms of CR were found in 8 cases of cervical TFLs. The correlation between nerve root entrapment by the cervical TFL and CR showed a 96.8% specificity and an 80% sensitivity. In the 10 healthy subjects, cervical TFLs were present in 13 intervertebral foramina.
Conclusions
The MR 3D-FIESTA sequence has high clinical value in displaying cervical TFLs in both cadavers and living bodies. If 3D-FIESTA sequencing shows nerve entrapment by the TFL, the possibility of CR caused by this TFL is approximately 80.0%. Conversely, the possibility of CR remains at 3.2%.