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C2 Nerve Root on Magnetic Resonance Imaging of Occipital Neuralgia

Cited 6 time in Web of Science Cited 6 time in Scopus

Yi, Minkyung; Lee, Joon Woo; Yeom, Jin S.; Joe, Eugene; Hong, Sung Hwan; Lee, Guen Young; Kang, Heung Sik

Issue Date
Lippincott Williams & Wilkins
Spine, vol.39 no.13, pp. 1077 - 1083
cervicogenic headacheoccipital neuralgiacervical
magnetic resonance imagingC1–C2 neural foramen
Study Design. Review and grade the morphology of the C1–C2
neural foramina, from the MR images of patients who underwent
C1–C2 spinal surgery, and determine the relationship with ON.
Objective. To evaluate the feasibility of MRI for C1–C2 neural
foramen evaluation with a new grading system and to correlate the
C1–C2 neural foramen grade with ON.
Summary of Background Data. There have been no MRI
studies of patients with and without ON in relation to C2 nerve root
ganglion fi ndings.
Methods. Among the registry of 124 patients who underwent
C1–C2 spinal surgery between July 2004 and May 2012 in Seoul
National University Bundang Hospital, we enrolled 101 patients
who had information about ON and a relevant preoperative cervical
spine MR image. A total of 202 neural foramina were evaluated
with our new C1–C2 neural foramen grading system (grade, 0–3)
using consensus reading by 2 experienced radiologists who were
blinded to the clinical information. The relationship between the
C1–C2 grading system and ON was assessed using a χ2
test and
Fisher exact test. Inter- and intraobserver reliability agreement was
assessed using the κ statistic.
Results. All C1–C2 neural foramina were delineated on T2
parasagittal images. Among 202 C1–C2 neural foramina, grade zero
was found in 49 foramina (24.3%), grade 1 in 95 (47.0%), grade 2
in 30 (14.9%), and grade 3 in 28 (13.9%). Grade 1 stenosis was
most frequently noted. The grade 2 group had the most frequent
prevalence of ON (43.3%), followed by grade 3 (35.7%), grade
zero (30.6%), and grade 1 (29.5%). However, the relationship
between the grade and ON was not statistically signifi cant. Interand
intraobserver agreements were substantially high. Conclusion. C1–C2 neural foramina can be depicted on MR
image. However, the relationship between the new grading system
for C1–C2 neural foramina and ON was not statistically signifi cant.
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