The Role of Oblique Lateral Radiographs and Oblique Sagittal MRI in Diagnosing Cervical Radiculopathy and Myeloradiculopathy: A Correlative Analysis

Cases with cervical spine radicular symptoms are on a rise due to demographic shift towards more ageing population, poor ergonomics related to occupation, lack of physical exercises and sedentary lifestyles. A significant proportion of these symptoms are due to the compression of cervical nerve roots at the intervertebral foramen level. This compression can be attributed to disc degeneration and lateral herniation, uncinate process osteophytes and facetal overgrowth that results into narrowing of the exiting neural foramen causing foraminal stenosis . The anatomical orientation of these foramen is oblique, lying around 45° from the sagittal plane. Hence, standard anteroposterior (AP) and lateral view radiographs of cervical spine do not provide much inference regarding the status of cervical inter-vertebral foramen, as compared to 45° oblique angled radiographs where x-rays are projected perpendicular to the foramen cross-section and its boundaries can be outlined. Similarly, traditional sagittal MRI images are also unable to provide clear views of the foramen, whereas the 45° oblique sagittal view creates a cervical image similar to lumbar sagittal views . This can facilitate in correct diagnosis of cervical intervertebral foraminal stenosis and predict prognosis and determine appropriate treatment options.