Publication: Use of Neurodynamic or Orthopedic Tension Tests for the Diagnosis of Lumbar and Lumbosacral Radiculopathies: Study of the Diagnostic Validity.
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Date
2020-09-26
Authors
González Espinosa de Los Monteros, Francisco Javier
Gonzalez-Medina, Gloria
Ardila, Elisa Maria Garrido
Mansilla, Juan Rodríguez
Expósito, José Paz
Ruiz, Petronila Oliva
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Abstract
Lumbar radiculopathy is a nerve root disorder whose correct diagnosis is essential. The objective of the present study was to analyze the reliability diagnostic validity of eight neurodynamic and/or orthopedic tension tests using magnetic resonance imaging as the Gold Standard. An epidemiological study of randomized consecutive cases which was observational, descriptive, transversal, double blinded and was conducted following the Standards for Reporting Diagnostic accuracy studies (STARD) declaration. The sample size was 864 participants. Internal and external validity (CI = 95%) and reliability, were calculated for all tests performed independently. The diagnostic validity of the combined and multiple tests in parallel was also calculated. The analysis indicated that only two tests performed independently had external validity, but neither had reliability or precision. The Straight Leg Raise test and the Bragard test performed in a multiple parallel way showed high sensitivity (97,40%), high negative predictive value (PV- 96,64%) and external validity (Likelihood Ratio- 0,05). The combined test of the Slump test and the Dejerine's triad had internal and external validity. The Straight Leg Raise test and the Bragard test performed in a multiple parallel way and the combined test of the Slump Test and the Dejerine's triad have clinical validity to discard lumbar or lumbar-sacral radiculopathy.
Description
MeSH Terms
Exercise Test
Female
Humans
Low Back Pain
Lumbar Vertebrae
Lumbosacral Region
Magnetic Resonance Imaging
Male
Neurologic Examination
Physical Examination
Radiculopathy
Reproducibility of Results
Sensitivity and Specificity
Spinal Nerve Roots
Female
Humans
Low Back Pain
Lumbar Vertebrae
Lumbosacral Region
Magnetic Resonance Imaging
Male
Neurologic Examination
Physical Examination
Radiculopathy
Reproducibility of Results
Sensitivity and Specificity
Spinal Nerve Roots
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Keywords
lumbar radiculopathy, magnetic resonance, neurodynamic tension tests, orthopedic tension tests