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Accuracy of clinical neurological examination in diagnosing lumbo-sacral radiculopathy: a systematic literature review

Overview of attention for article published in BMC Musculoskeletal Disorders, February 2017
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  • In the top 5% of all research outputs scored by Altmetric
  • High Attention Score compared to outputs of the same age (91st percentile)

Mentioned by

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37 tweeters
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14 Facebook pages
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1 Google+ user

Citations

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3 Dimensions

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210 Mendeley
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Title
Accuracy of clinical neurological examination in diagnosing lumbo-sacral radiculopathy: a systematic literature review
Published in
BMC Musculoskeletal Disorders, February 2017
DOI 10.1186/s12891-016-1383-2
Pubmed ID
Authors

Nassib Tawa, Anthea Rhoda, Ina Diener

Abstract

Lumbar radiculopathy remains a clinical challenge among primary care clinicians in both assessment and diagnosis. This often leads to misdiagnosis and inappropriate treatment of patients resulting in poor health outcomes, exacerbating this already debilitating condition. This review evaluated 12 primary diagnostic accuracy studies that specifically assessed the performance of various individual and grouped clinical neurological tests in detecting nerve root impingement, as established in the current literature. Eight electronic data bases were searched for relevant articles from inception until July 2016. All primary diagnostic studies which investigated the accuracy of clinical neurological test (s) in diagnosing lumbar radiculopathy among patients with low back and referred leg symptoms were screened for inclusion. Qualifying studies were retrieved and independently assessed for methodological quality using the 'Quality Assessment of Diagnostic tests Accuracy Studies' criteria. A total of 12 studies which investigated standard components of clinical neurological examination of (sensory, motor, tendon reflex and neuro-dynamics) of the lumbo-sacral spine were included. The mean inter-observer agreement on quality assessment by two independent reviewers was fair (k = 0.3 - 0.7). The diagnostic performance of sensory testing using MR imaging as a reference standard demonstrated a sensitivity (confidence interval 95%) 0.61 (0.47-0.73) and a specificity of 0.63 (0.38-0.84). Motor tests sensitivity was poor to moderate, ranging from 0.13 (0.04-0.31) to 0.61 (0.36-0.83). Generally, the diagnostic performance of reflex testing was notably good with specificity ranging from (confidence interval 95%) 0.60 (0.51-0.69) to 0.93 (0.87-0.97) and sensitivity ranging from 0.14 (0.09-0.21) to 0.67 (0.21-0.94). Femoral nerve stretch test had a high sensitivity of (confidence interval 95%) 1.00 (0.40-1.00) and specificity of 0.83 (0.52-0.98) while SLR test recorded a mean sensitivity of 0.84 (0.72-0.92) and specificity of 0.78 (0.67-0.87). There is a scarcity of studies on the diagnostic accuracy of clinical neurological examination testing. Furthermore there seem to be a disconnect among researchers regarding the diagnostic utility of lower limb neuro-dynamic tests which include the Straight Leg Raise and Femoral Nerve tests for sciatic and femoral nerve respectively. Whether these tests are able to detect the presence of disc herniation and subsequent nerve root compression or hyper-sensitivity of the sacral and femoral plexus due to mechanical irritation still remains debatable.

Twitter Demographics

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Mendeley readers

The data shown below were compiled from readership statistics for 210 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Netherlands 2 <1%
Australia 1 <1%
Portugal 1 <1%
Unknown 206 98%

Demographic breakdown

Readers by professional status Count As %
Student > Master 43 20%
Other 38 18%
Student > Bachelor 35 17%
Student > Doctoral Student 20 10%
Unspecified 18 9%
Other 56 27%
Readers by discipline Count As %
Medicine and Dentistry 99 47%
Nursing and Health Professions 65 31%
Unspecified 21 10%
Sports and Recreations 8 4%
Neuroscience 3 1%
Other 14 7%

Attention Score in Context

This research output has an Altmetric Attention Score of 25. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 01 August 2019.
All research outputs
#646,543
of 13,451,724 outputs
Outputs from BMC Musculoskeletal Disorders
#121
of 2,656 outputs
Outputs of similar age
#23,099
of 258,424 outputs
Outputs of similar age from BMC Musculoskeletal Disorders
#1
of 1 outputs
Altmetric has tracked 13,451,724 research outputs across all sources so far. Compared to these this one has done particularly well and is in the 95th percentile: it's in the top 5% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 2,656 research outputs from this source. They typically receive a little more attention than average, with a mean Attention Score of 6.0. This one has done particularly well, scoring higher than 95% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 258,424 tracked outputs that were published within six weeks on either side of this one in any source. This one has done particularly well, scoring higher than 91% of its contemporaries.
We're also able to compare this research output to 1 others from the same source and published within six weeks on either side of this one. This one has scored higher than all of them