EVALUATION OF CHANGES IN THE ROOTS OF CERVICAL AND BRACHIAL PLEXUSES IN AVULSION INJURIES

Abstract

Introduction. Methods of radiologic imaging have taken a leading place in the assessment of damage to the roots of the cervical and brachial plexuses. One of the variants of damage is avulsion injury with partial or complete detachment of the nerve root at the place of its exit from the spinal cord. The leading position in the visualization of such lesion, until recently, was occupied by computed tomographic myelography. At the same time, it has a number of disadvantages, and therefore the search for alternative imaging methods remains relevant. Aim. To study the opportunities of assessing avulsion damage to the roots of the cervical and brachial ple¬xuses in avulsion injuries in patients with traction injury using 3D-CISS technique in comparison with CT-myelography. Materials and methods. The study included 50 patients of both sexes hospitalized at the Federal State Budgetary Institution "Federal Neurosurgical Center " of the Ministry of Health of Russia with avulsion injuries in the roots of the cervical or brachial plexuses of traction origin. The studies were performed on MRI scanners with a magnetic field strength of 1.5 Tesla using the 3D-CISS MRI technique and CT-myelography in a neurosurgical hospital using a Siemens SOMATOM Definintion AS spiral tomograph. The patients underwent surgical reconstruction of the avulsion lesion of the nerve roots. Results. Features of injuries to the nerve roots of the cervical and brachial plexus: possible visualization of pseudomeningocele with CT-myelography and 3DCISS technique, visualization of an interrupted root course with 3D-CISS technique. With the 3DCISS technique, the data corresponded to intraoperative data more often than with CT-myelography. The results of the MRI method using the 3D-CISS technique are more reliable in comparison with CT myelography in the assessment of pathological changes in the nerve roots. Conclusion. 3D-CISS is a more effective technique for visualizing nerve root avulsion injury compared to CT-myelography.