Neurological testing limited in diagnosing disc herniation

Neurological testing limited in diagnosing disc herniation
Neurological testing procedures have limited diagnostic accuracy for detecting disc herniation with suspected radiculopathy, according to a review and meta-analysis published in the June issue of The Spine Journal.

(HealthDay)—Neurological testing procedures have limited diagnostic accuracy for detecting disc herniation with suspected radiculopathy, according to a review and meta-analysis published in the June issue of The Spine Journal.

Nezar H. Al Nezari, P.T., M.Phty., from the University of Otago in New Zealand, and colleagues conducted a review to examine the diagnostic accuracy of neurological examination to detect lumbar disc herniation with suspected radiculopathy. Fourteen studies that investigated three standard neurological examination components (sensory, motor, and reflexes) were included.

The researchers found that, using pooled data from sensory testing, there was low diagnostic sensitivity for surgically and radiologically confirmed disc herniation (0.40 and 0.32, respectively) and for identification of a specific level of disc herniation (0.35), while specificity was moderate for all three reference standards (0.59, 0.72, and 0.64, respectively). Pooled diagnostic sensitivities were similarly low with motor testing for paresis (0.22 for surgically and 0.40 for radiologically determined disc herniation), while specificity was moderate (0.79 and 0.62, respectively). For surgically determined disc herniation, motor testing for resulted in a pooled sensitivity of 0.31 and specificity of 0.76. For surgically and radiologically confirmed levels of disc herniation, the pooled sensitivities for testing were 0.29 and 0.25, respectively, while the specificities were 0.78 and 0.75, respectively. For all components the pooled positive likelihood ratios ranged from 1.02 to 1.26.

"This systematic review and meta-analysis demonstrate that neurological testing procedures have limited overall in detecting disc herniation with suspected radiculopathy," the authors write.

More information: Abstract
Full Text (subscription or payment may be required)

add to favorites email to friend print save as pdf

Related Stories

Improved driving reaction times after lumbar disc sx

Jan 15, 2013

(HealthDay)—Driving reaction times (DRTs), which are increased for patients with radiculopathy, improve after lumbar disc surgery, according to a study published in the November issue of the European Sp ...

Less benefit for obese with lumbar disc herniation tx

Feb 08, 2013

(HealthDay)—Obese patients derive less benefit from both operative and non-operative lumbar disc herniation treatment, according to a study published in the Jan. 2 issue of The Journal of Bone & Joint Su ...

Recommended for you

Two US states order tough Ebola quarantine rules

10 hours ago

New York and New Jersey on Friday ordered a mandatory quarantine for medics who treated victims of Ebola in West Africa, after the deadly virus spread to America's largest city.

NY and NJ say they will require Ebola quarantines

Oct 24, 2014

The governors of New Jersey and New York on Friday ordered a mandatory, 21-day quarantine for all doctors and other arriving travelers who have had contact with Ebola victims in West Africa.

User comments