Obstetric XXXX : CT myelography.

@entity1 @entity5300 @entity155 @entity9007
PURPOSE: To evaluate the value of computed tomographic (CT) myelography in the detection of root damage and differentiation of root @entity155 from neurotmesis in a large cohort of @entity1 with an obstetric @entity5300 (OBPL). MATERIALS AND METHODS: Institutional review board approval was obtained. Informed consent was waived by the medical ethics committee. One hundred eighteen @entity1 with OBPL born in the cephalic position and six @entity1 born in the breech position were selected for surgery by two neurosurgeons in a multidisciplinary team. Functional loss of the C5 through T1 innervated muscles was noted. All @entity1 underwent preoperative CT myelography at an average age of 19 weeks. CT myelographic examination results were reviewed by two radiologists, who were blinded to the clinical findings, for the presence of root @entity155 and @entity9007 . Interobserver agreement was assessed by calculating k values. RESULTS: CT myelographic results showed root @entity155 in at least one level in 66 (56%) of 118 @entity1 born in the cephalic position and in six (100%) of six @entity1 born in the breech position. Levels C7 and C8 showed the most root @entity155 , even if not expected from clinical examination results. A large number of root @entity155 showed @entity9007 (73 [68%] of 107 levels in @entity1 born in the cephalic position and 11 [73%] of 15 levels in @entity1 born in the breech position). CONCLUSION: CT myelographic results showed root @entity155 in more than half of @entity1 with OBPL. Root @entity155 were even detected at levels that were not expected at clinical examination. Because root @entity155 require specific reconstructive techniques, CT myelography is recommended for every preoperative @entity1 with OBPL.
