A dose–response study of prostaglandin E1 on nerve root blood flow velocity and neurologic symptoms after lumbar spinal decompression in surgical patients

Eligibility Criteria of Participants in Randomized Controlled Trials Assessing Conservative Management of Cervical Radiculopathy: A Systematic Review

“…Of the 68 studies, 54 included at least two categories (clinical symptoms, clinical examination tests, and/or imaging),13–73 with 12 studies including participants based on clinical symptoms alone74–85 and two including participants based on clinical examination findings alone 86,87. Twenty-six trials required clinical symptoms in addition to positive clinical examination tests,17–19,25,27,29,30,33,42,43,45–47,51,52,54,56,59,60,62,63,65,67,68,70–72,88 six trials required clinical symptoms in addition to imaging,14,15,24,35,41,53,61,73 two required physical examination findings in addition to imaging,39,48 and 20 required clinical symptoms in addition to positive clinical examination tests and imaging 13,16,20–23,28,31,32,34,36–38,40,44,49,50,55,57,58,64,66,69…”

“…Of the 68 distinct trials, all but four included information on the inclusion of participants based on clinical symptoms 39,48,86,87. The most common symptom mentioned as an inclusion criterion in 47/68 studies was arm pain with or without another symptom such as numbness, paresthesia, or weakness13–25,27,28,30–34,36,37,41,43–45,47,49–52,58–61,64,67–71,73,81,82,84 and 34/68 studies included neck symptoms such as pain and limited range of motion (ROM) 13,16,25,28–30,32–37,40,41,44,46,51,52,54,56,60,62–64,67,68,73,75,78,79,81–84,88. Other less mentioned symptomatology included arm/hand numbness and/or paresthesia in isolation, with 12 studies listing “clinical symptoms” of CR without further description 29,38,42,65,72,74–77,80,85,88…”

“…Of the 68 distinct trials, 50 required at least one positive clinical examination test for participant inclusion 13,16–23,25–34,36–40,42–52,54–60,62–72,86–89. Sixteen trials included the Wainner cluster of tests (Spurling, ULTT, cervical distraction test, cervical ROM<60°), with 12 requiring three out of four positive tests,26,43,46,56,58–60,62,63,65,68,71 while four trials required all four to be positive 27,49,50,88.…”

“…Of the 68 distinct trials, 22 included a description of participants suffering from a specific etiology (disk herniation and/or cervical spondylosis) 13–16,20–25,28,34,35,38–40,44,48–50,53,61,64,69,76,77,79,85. In the 22 trials, there was a relatively equal split between which etiology was included and assessed in the study.…”

“…Forty-five trials included red flag conditions as exclusion criteria such as previous trauma, infection, and malignancy,13–16,25,27–31,33,35–37,41,42,44,47–52,54–57,59,60,62,63,65,67–71,73–75,78,81,83,84,88 27 excluded participants who underwent previous cervical spine surgery,13–19,24,25,27,30–33,39,41,44,46,47,49,50,53,60,62,63,65,67–70,78,88 and three excluded participants who had an indication for surgery (ineffective nonsurgical treatment for three to six months, relapse of severe symptoms that impacted daily life, or progressive and severe neurological deficits) 38,53,79. Twelve trials excluded participants who had bilateral upper extremity symptoms27,28,46,50,58–60,62,63,65,86,88 and 40 trials excluded participants who had signs of cervical myelopathy/stenosis 13–18,20–24,27,28,30–36,38,40,45,46,48,49,54–59,62,63,65,67–70,76,78,81,82,84–86,88. Excluding participants with cervical myelopathy is important due to the severity and distinct patient symptoms that are experienced with this condition in comparison to CR 90…”