Asymptomatic degenerative disk disease and spondylosis of the cervical spine: MR imaging.

Teresi, L M; Lufkin, R B; Reicher, Murray A.; Moffit, Brian; Viñuela, Fernando; Wilson, Gabriel; Bentson, John R.; Hanafee, William N.

doi:10.1148/radiology.164.1.3588931

Cited by 337 publications

(151 citation statements)

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“…A recent, comprehensive review determined that needle EMG has a sensitivity of 50-71% for subjects with neurological or radiological signs of a cervical radiculopathy, although the lack of a standardized gold standard may have resulted in an underestimation of this figure [7,8]. On the other hand, asymptomatic radiological abnormalities are commonly seen with advanced imaging studies [17,20,26,37,58]. It is well accepted that the diagnostic accuracy of specialized imaging is limited, especially with regards to foraminal nerve root impingement [11,15,38].…”

Section: Introductionmentioning

confidence: 99%

A systematic review of the diagnostic accuracy of provocative tests of the neck for diagnosing cervical radiculopathy

et al. 2006

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Clinical provocative tests of the neck, which position the neck and arm inorder to aggravate or relieve arm symptoms, are commonly used in clinical practice in patients with a suspected cervical radiculopathy. Their diagnostic accuracy, however, has never been examined in a systematic review. A comprehensive search was conducted in order to identify all possible studies fulfilling the inclusion criteria. A study was included if: (1) any provocative test of the neck for diagnosing cervical radiculopathy was identified; (2) any reference standard was used; (3) sensitivity and specificity were reported or could be (re-)calculated; and, (4) the publication was a full report. Two reviewers independently selected studies, and assessed methodological quality. Only six studies met the inclusion criteria, which evaluated five provocative tests. In general, Spurling's test demonstrated low to moderate sensitivity and high specificity, as did traction/neck distraction, and Valsalva's maneuver. The upper limb tension test (ULTT) demonstrated high sensitivity and low specificity, while the shoulder abduction test demonstrated low to moderate sensitivity and moderate to high specificity. Common methodological flaws included lack of an optimal reference standard, disease progression bias, spectrum bias, and review bias. Limitations include few primary studies, substantial heterogeneity, and numerous methodological flaws among the studies; therefore, a meta-analysis was not conducted. This review suggests that, when consistent with the history and other physical findings, a positive Spurling's, traction/neck distraction, and Valsalva's might be indicative of a cervical radiculopathy, while a negative ULTT might be used to rule it out. However, the lack of evidence precludes any firm conclusions regarding their diagnostic value, especially when used in primary care. More high quality studies are necessary in order to resolve this issue.

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Section: Introductionmentioning

confidence: 99%

A systematic review of the diagnostic accuracy of provocative tests of the neck for diagnosing cervical radiculopathy

et al. 2006

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“…Magnetic Resonance Imaging (MRI) is the imaging modality of choice [26] One study showed cord impingement in 16% of asymptomatic patients under age 64 years and in 26% of asymptomatic patients aged greater than 64 [27]. In those where MRI is contraindicated or not tolerated, contrastenhanced CT may be used which is just as useful in characterizing compression of the spinal cord.…”

Section: Investigationsmentioning

confidence: 99%

“…Cervical spondylotic myelopathy is the most common cause of cervical spinal cord dysfunction in individuals older than 55 [2]. By the age of 40, most will have degenerative changes evident on radiographs [3]. In fact, by age 60-65 years, 95% of asymptomatic men and 70% of asymptomatic women show degenerative changes on plain films [4].…”

Section: Introductionmentioning

confidence: 99%

Cervical Myelopathy: Pathophysiology, Diagnosis, and Management

Virdi¹

2017

Spine Res

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The natural history of cervical myelopathy involves both static and dynamic factors which trigger a cascade of reactions resulting in cord compression and ischemic dysfunction of the spinal cord. Conservative management is an option in those with mild Cervical Spondylotic Myelopathy (CSM), though close clinical and radiological follow-up is important. Operative management remains the standard of treatment for more symptomatic CSM, however, indications must be carefully considered with each individual patient. A randomized, double-blind, placebo-controlled multi-centre study, assessing whether Riluzole (a neuroprotective drugs) has any benefits as a treated for surgical decompression in those with CSM, is being carried out. Here we review the pathophysiological, diagnostic and treatment aspects of CSM.

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“…By the age of 30, virtually all individuals will have at least microscopic degenerative changes in their cervical spine 2 .…”

Section: Introductionmentioning

confidence: 99%

MRI Signal Intensity Changes in Cervical Spondylotic Myelopathy and Its Role in Assessing the Surgical Prognosis

Jacob¹

2017

JMSCR

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Asymptomatic degenerative disk disease and spondylosis of the cervical spine: MR imaging.

Cited by 337 publications

References 0 publications

A systematic review of the diagnostic accuracy of provocative tests of the neck for diagnosing cervical radiculopathy

A systematic review of the diagnostic accuracy of provocative tests of the neck for diagnosing cervical radiculopathy

Cervical Myelopathy: Pathophysiology, Diagnosis, and Management

MRI Signal Intensity Changes in Cervical Spondylotic Myelopathy and Its Role in Assessing the Surgical Prognosis

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