Evaluating cervical spine MRIs just got a whole lot more revealing, and I have to share this with you. Here is a patient with neck pain, vague radiation across his shoulder blades, and right shoulder weakness compared to his left. There is a disc protrusion at C4-5 affecting the C5 nerve root. On the standard parasagittal images you can kind of see something going on, but you cannot really see the opening because the neural foramen runs at 45 degrees while the standard slices run straight up and down at 90 degrees. What you need is an oblique slice that is perpendicular to the foramen so you can see it in perfect cross section. That is exactly what this oblique image shows. When the slice is oriented directly in line with the neural foramen, look at what appears: a bone spur going right into the C4-5 neural foramen that you simply could not see on the standard views. The opposite side does not have that bony spike, and the difference is clear. I have been requesting oblique images across the neuroforamen in cases where I need to determine if it is pure neuroforaminal stenosis, and this is an extreme example of why. If you have weird arm pain you cannot figure out from standard MRIs, request oblique images to look at the neuroforamen because sometimes it will uncover things you might otherwise miss.
The information in this video is for educational purposes only and is not intended as medical advice. Surgical procedures shown may not be appropriate for all individuals. Viewing this content does not establish a physician patient relationship. Treatment decisions should be made by qualified healthcare professionals based on individual patient circumstances.
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