The Value of Provocative Tests in Diagnosis of Acute and Chronic Cervical Radiculopathy

Document Type : Original Article(s)

Authors

1 Assistant Professor, Department of Neurology, Isfahan Neuroscience Research Center, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.

2 Student of Medicine, Student Research Committee, Isfahan Neuroscience Research Center, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.

3 Associate Professor, Department of Neurology, Isfahan Neuroscience Research Center, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.

4 Professor, Department of Community Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.

Abstract

Background: The aim of this study was to assess the accuracy of shoulder abduction test (SAT), spurling test (ST) and upper limb tension test (ULTT) in diagnosis of acute or chronic cervical radiculopathy (CR) based on an electrodiagnostic reference criterion.Methods: Our tests and electromyography were done on 97 patients suffering from arm and neck pain. They were classified according to electrodiagnostic findings. Then diagnostic values of provocative tests were assessed in diagnosis of acute or chronic CR on the basis of reference criterion.Findings: SAT and ST were more specific compared to ULTT while ULTT was more sensitive than those two. SAT and ST had a significant accuracy for comparison between acute and chronic CR (P < 0.05). Conclusion: The ULTT is suitable for screening of CR, but SAT and ST can support diagnosis. The SAT and the ST are good diagnostic tests for comparison between acute and chronic CR.

Keywords

References

  1. Carette S, Fehlings MG. Clinical practice. Cervical radiculopathy. N Engl J Med 2005; 353(4): 392-9.
  2. Radhakrishnan K, Litchy WJ, O'Fallon WM, Kurland LT. Epidemiology of cervical radiculopathy. A population-based study from Rochester, Minnesota, 1976 through 1990. Brain 1994; 117(Pt 2): 325-35.
  3. Bogduk N. The anatomy and pathophysiology of neck pain. Phys Med Rehabil Clin N Am 2003; 14(3): 455-72, v.
  4. Abbed KM, Coumans JV. Cervical radiculopathy: pathophysiology, presentation, and clinical evalu-ation. Neurosurgery 2007; 60(1 Supp1 1): S28-S34.
  5. Kuijper B, Tans JT, Schimsheimer RJ, van der Kallen BF, Beelen A, Nollet F, et al. Degenerative cervical radiculopathy: diagnosis and conservative treatment. A review. Eur J Neurol 2009; 16(1): 15-20.
  6. Shelerud RA, Paynter KS. Rarer causes of radiculopathy: spinal tumors, infections, and other unusual causes. Phys Med Rehabil Clin N Am 2002; 13(3): 645-96.
  7. Wainner RS, Fritz JM, Irrgang JJ, Boninger ML, Delitto A, Allison S. Reliability and diagnostic accuracy of the clinical examination and patient self-report measures for cervical radiculopathy. Spine (Phila Pa 1976) 2003; 28(1): 52-62.
  8. Heiskari M. Comparative retrospective study of patients operated for cervical disc herniation and spondylosis. Ann Clin Res 1986; 18(Suppl 47): 57-63.
  9. Rubinstein SM, Pool JJ, van Tulder MW, Riphagen II, de Vet HC. A systematic review of the diagnostic accuracy of provocative tests of the neck for diagnosing cervical radiculopathy. Eur Spine J 2007; 16(3): 307-19.
  10. Wainner RS, Gill H. Diagnosis and nonoperative management of cervical radiculopathy. J Orthop Sports Phys Ther 2000; 30(12): 728-44.
  11. Saal JS. The role of inflammation in lumbar pain. Spine (Phila Pa 1976 ) 1995; 20(16): 1821-7.
  12. Davidson RI, Dunn EJ, Metzmaker JN. The shoulder abduction test in the diagnosis of radicular pain in cervical extradural compressive monoradiculopathies. Spine (Phila Pa 1976) 1981; 6(5): 441-6.
  13. Viikari-Juntura E, Porras M, Laasonen EM. Validity of clinical tests in the diagnosis of root compression in cervical disc disease. Spine (Phila Pa 1976) 1989; 14(3): 253-7.
  14. Tong HC, Haig AJ, Yamakawa K. The Spurling test and cervical radiculopathy. Spine (Phila Pa 1976) 2002; 27(2): 156-9.
  15. Shah KC, Rajshekhar V. Reliability of diagnosis of soft cervical disc prolapse using Spurling's test. Br J Neurosurg 2004; 18(5): 480-3.
  16. Quintner JL. A study of upper limb pain and paraesthesiae following neck injury in motor vehicle accidents: assessment of the brachial plexus tension test of Elvey. Br J Rheumatol 1989; 28(6): 528-33.
Journal of Isfahan Medical School
Volume 29, Issue 143 - Serial Number 143
May and June 2011
Pages 744-751

Files

History

  • Receive Date: 04 July 2011
  • Revise Date: 01 November 2024
  • Accept Date: 06 April 2022

Share

How to cite

Statistics