Classification criteria for cervical radiculopathy: An international e-Delphi study

Lam, Kwun N.; Heneghan, Nicola R; Mistry, Jai; Ojoawo, Adesola Ojo; Peolsson, Anneli; Verhagen, Arianne P.; Tampin, Brigitte; Thoomes, Erik; Jull, Gwendolen; Scholten-Peeters, Gwendolyne G M; Slater, Helen; Moloney, Niamh; Hall, Toby; Dedering, Åsa; Rushton, Alison; Falla, Deborah

doi:10.1016/j.msksp.2022.102596

Cited by 10 publications

(28 citation statements)

References 53 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…This is in line with a recent systematic review suggesting the use of nine different classification criteria for future trials involving people with cervical radiculopathy 40 . High‐quality evidence for a singular classification criterion is not currently available and experts agree that self‐reported symptoms and objective findings should be clustered during the diagnostic procedures 41 . Pain drawings have the potential to improve the evaluation of neuropathic pain, 42 especially when integrated with the medical imaging and provocative tests.…”

Section: Discussionsupporting

confidence: 62%

“… 40 High‐quality evidence for a singular classification criterion is not currently available and experts agree that self‐reported symptoms and objective findings should be clustered during the diagnostic procedures. 41 Pain drawings have the potential to improve the evaluation of neuropathic pain, 42 especially when integrated with the medical imaging and provocative tests.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Determining the level of cervical radiculopathy: Agreement between visual inspection of pain drawings and magnetic resonance imaging

et al. 2022

Self Cite

View full text Add to dashboard Cite

Background and Aims: Pain drawings are commonly used in the clinical assessment of people with cervical radiculopathy. This study aimed to assess (1) the agreement of clinical interpretation of pain drawings and MRI findings in identifying the affected level of cervical radiculopathy, (2) the agreement of these predictions based on the pain drawing among four clinicians from two different professions (i.e., physiotherapy and surgery) and (3) the topographical pain distribution of people presenting with cervical radiculopathy (C4-C7).Methods: Ninety-eight pain drawings were obtained from a baseline assessment of participants in a randomized clinical trial, in which single-level cervical radiculopathy was determined using MRI. Four experienced clinicians independently rated each pain drawing, attributing the pain distribution to a single nerve root (C4-C7). A post hoc analysis was performed to assess agreement.Outcome measures: Percentage agreement and kappa values were used to assess the level of agreement. Topographic pain frequency maps were created for each cervical radiculopathy level as determined by MRI. Results:The radiculopathy level determined from the pain drawings showed poor overall agreement with MRI (mean = 35.7%, K = −0.007 to 0.139). The interclinician agreement ranged from fair to moderate (K = 0.212-0.446). Topographic frequency maps revealed that pain distributions were widespread and overlapped markedly between patients presenting with different levels cervical radiculopathy. Conclusion:This study revealed a lack of agreement between the segmental level affected determined from the patient's pain drawing and the affected level as identified on MRI. The large overlap of pain and non-dermatomal distribution of pain reported by patients likely contributed to this result.

show abstract

Section: Discussionsupporting

confidence: 62%

Section: Discussionmentioning

confidence: 99%

Determining the level of cervical radiculopathy: Agreement between visual inspection of pain drawings and magnetic resonance imaging

et al. 2022

Self Cite

View full text Add to dashboard Cite

show abstract

“…In this review, half of the studies included this as an inclusion criterion. The third criterion was selected as based on expert consensus and a diagnostic study, it is suggested that CR patients exhibit arm pain greater than neck pain 93,105,106. The fourth criterion was selected as despite clinical symptoms being indicative of CR, relying on them in isolation for the diagnosis of CR is not recommended due to their limited diagnostic value 93,97.…”

Section: Discussionmentioning

confidence: 99%

“…The third criterion was selected as based on expert consensus and a diagnostic study, it is suggested that CR patients exhibit arm pain greater than neck pain. 93,105,106 The fourth criterion was selected as despite clinical symptoms being indicative of CR, relying on them in isolation for the diagnosis of CR is not recommended due to their limited diagnostic value. 93,97 Therefore, confirmatory tests, specifically tests with high specificity should be used when determining classification criteria for research to limit false-positive results.…”

Section: Proposed Recommended Inclusion Criteria and Justificationmentioning

confidence: 99%

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

Plener

Silva-Oolup

et al. 2022

Spine

View full text Add to dashboard Cite

Study Design. Systematic review. Objective. The aim of this study was to evaluate the inclusion and exclusion criteria for participants in randomized control trials (RCTs) assessing conservative management for cervical radiculopathy (CR), to determine if any consensus exists within the literature. Summary of Background Data. A 2012 systematic review identified a lack of uniformity for the eligibility criteria of participants in RCTs evaluating conservative interventions for CR. Since then, a large number of RCTs have been published, signaling the need for an updated evaluation of this topic. Materials and Methods. We electronically searched MEDLINE, CENTRAL, CINAHL, Embase, and PsycINFO from inception to June 15, 2022, to identify RCTs assessing conservative management of CR. Information extracted was analyzed to determine the level of homogeneity and/or heterogeneity of the inclusion and exclusion criteria across studies. Results. Seventy-six RCTs met our inclusion criteria with 68 distinct trials identified. The inclusion of arm pain with or without another symptom (i.e. numbness, paresthesia, or weakness) was required in 69.12% of trials, 50% of trials required participants to exhibit neck symptoms, and 73.53% of studies required some form of clinical examination findings, but inconsistencies existed for the number and type of tests used. Furthermore, 41.18% of trials included imaging, with 33.82% of trials requiring magnetic resonance imaging findings. The most common exclusion criteria included were the presence of red flags and cervical myelopathy in 66.18% and 58.82% of trials, respectively. Conclusions. Overall, there is still a lack of uniformity for the inclusion/exclusion criteria of trials assessing the conservative management of CR, with some improvements noted compared with the 2012 review. Based on the current literature assessing the diagnostic utility of clinical symptoms and confirmatory tests, we proposed inclusion criteria for trials assessing conservative interventions. Future research should aim to develop standardized classification criteria to improve consistency among studies.

show abstract

“…to have experienced neck pain in the prior six months. 6 Physiotherapy as exercise therapy, manual therapy in various specialized approaches, electrotherapies, minimally invasive procedures, assistive gadgets, and lifestyle changes are only a few of the treatment possibilities included in conservative treatment. 7 By using therapeutic messages, oscillatory motions, mobilization, manipulative therapies, stretching, and structural correction, registered professionals can passively support healing while reducing uncomfortable symptoms, regaining mobility, and reducing handicap.…”

Section: Introductionmentioning

confidence: 99%

"Outcome evaluation of physiotherapy & drug management for chronic cervical radiculopathy"

Siddique¹,

Rahman²,

Islam³

et al. 2023

MOJSM

View full text Add to dashboard Cite

Background: Cervical radiculopathy (CR) is one of the prevalent causes of neck pain and disability. Physiotherapy and pain medications are the common nonoperative management, and in Physiotherapy, there are many concepts of assessment and management. This study aims to determine the comparative effectiveness of three specialized physiotherapy approaches or only pain medications for managing CR cases. Methods: A prospective, assessor, and participant-blind, four-arm Randomized control trial (RCT) has been conducted on 120 patients with chronic cervical radiculopathy in 4 specialized centers of Dhaka city recruited between July and December 2022. Four groups (n=30) was treated through structural diagnosis and management concept (SDM), regional approaches (RA), McKenzie mechanical diagnosis and therapy (MDT) concept prescribed by advanced practice physiotherapist (APP), or pain medications prescribed by the specialist physician for 4 weeks. Discussion: After 24 sessions every group shows improvement in neck pain, ROM, disability and quality of life. During intermediate analysis (14days), no group shows more significant changes than another. After post changes (24days) the pain severity score differ significantly only between Medication and RA, RA and Medication; mean pain affective interference score differ between Medication and RA, RA and Medication; and pain physical interference between Medication and RA; RA and Medication. Mean score of ROM were significantly different between medication and RA, Medication and SDM; MDT and RA, MDT and SDM; RA and Medication, RA and MDT; SDM and Medication, SDM and MDT. Besides mean score of WHOQOL Brief (physical) were significantly different between Medication and SDM (p=.000); MDT and SDM (p=.000); RA and SDM (p=.045); SDM and Medication (p=.000), SDM and MDT (p=.000), SDM and RA. Overall improvement (mean score changes) found in pain, ROM, disability, QOL among all groups. Trial registered to the Clinical Trial Registry India CTRI/2022/03/040922 on 08/03/2022.

show abstract

Classification criteria for cervical radiculopathy: An international e-Delphi study

Cited by 10 publications

References 53 publications

Determining the level of cervical radiculopathy: Agreement between visual inspection of pain drawings and magnetic resonance imaging

Determining the level of cervical radiculopathy: Agreement between visual inspection of pain drawings and magnetic resonance imaging

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

"Outcome evaluation of physiotherapy & drug management for chronic cervical radiculopathy"

Contact Info

Product

Resources

About