OBJECTIVES Radiating pain in degenerative scoliosis is primary indication for surgery. However, axial and sagittal MR images are limited for identifying nerve root compromise. Therefore, we aimed to assess the value of coronal images for evaluating nerve root compromise in degenerative scoliosis. METHODS Forty-six patients (mean 70 years; range 41-91 years; 8 men) with degenerative scoliosis were enrolled. Coronal images were added to routine MRI. Two radiologists independently reviewed 350 nerve roots in two MRI sets: sagittal images alone (set 1) and coronal and sagittal images combined (set 2). The following features were evaluated: interpedicular height, lateral osteophyte, asymmetric bulging disc, lateral listhesis, anterolisthesis, axial rotation angle, facet arthrosis, ligamentum flavum thickening, and pseudoarticulation. Symptomatic levels were determined by transforaminal selective nerve root block. RESULTS There were 80 symptomatic and 270 asymptomatic nerve roots. The sensitivity (86%) and accuracy (93%) of set 2 were significantly higher than set 1 (53% and 87%) for radiculopathy, while specificity was similar between two sets (set 1, 97%; set 2, 95%). The AUC was significantly different between two sets (set 1, 0.853; set 2, 0.942). The negative interpedicular height difference, longer lateral osteophyte, asymmetric bulging disc, lateral listhesis, negative axial rotation angle difference, and pseudoarticulation were associated with change of grades between set 1 and set 2. CONCLUSION Coronal images are helpful for diagnosing nerve root compromise in patients with degenerative scoliosis. KEY POINTS • Sagittal and axial images have low sensitivity for detection of extraforaminal nerve root compromise in degenerative scoliosis. • Addition of coronal images may improve the sensitivity in nerve root compromise. • The structural changes that may contribute to nerve root compromise can also be easily assessed with coronal images.

中文翻译：

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退行性腰椎侧弯：冠状图像对常规腰椎 MRI 神经根损害的附加价值。

目的 退行性脊柱侧凸的放射痛是手术的主要指征。然而，轴位和矢状位 MR 图像在识别神经根受损方面存在局限性。因此，我们的目的是评估冠状位图像在评估退行性脊柱侧凸神经根受损方面的价值。方法 46 名患有退行性脊柱侧凸的患者（平均 70 岁；范围 41-91 岁；8 名男性）被纳入研究。冠状图像被添加到常规 MRI 中。两名放射科医师独立检查了两组 MRI 中的 350 个神经根：单独的矢状位图像（第 1 组）以及冠状位和矢状位图像组合（第 2 组）。评估了以下特征：椎弓根高度、外侧骨赘、不对称膨出椎间盘、外侧滑脱、前滑移、轴向旋转角、小关节病、黄韧带增厚和假关节。通过椎间孔选择性神经根阻滞确定症状水平。结果有症状神经根80根，无症状神经根270根。对于神经根病，第 2 组的敏感性 (86%) 和准确度 (93%) 显着高于第 1 组（53% 和 87%），而两组之间的特异性相似（第 1 组，97%；第 2 组，95%） ). 两组之间的 AUC 显着不同（第 1 组，0.853；第 2 组，0.942）。椎弓根高度差负值、外侧骨赘较长、椎间盘不对称膨出、侧向滑脱、轴向旋转角度差负值和假关节与组 1 和组 2 的分级变化有关。 结论 冠状位图像有助于诊断患者的神经根损害患有退行性脊柱侧弯。要点 • 矢状位和轴位图像对于检测退行性脊柱侧凸的椎间孔外神经根损害的敏感性较低。• 添加冠状图像可能会提高神经根受损的敏感性。• 可能导致神经根受损的结构变化也可以通过冠状图像轻松评估。