Clinical classification criteria for radicular pain caused by lumbar disc herniation: the radicular pain caused by disc herniation (RAPIDH) criteria

Genevay, Stéphane; Courvoisier, Delphine S.; Konstantinou, Kika; Kovacs, Francisco M.; Marty, Marc; Rainville, James; Norberg, Michael; Kaux, Jean-François; Thomas, D.; Katz, Jeffrey N.; Atlas, Steven J.

doi:10.1016/j.spinee.2017.05.005

Cited by 30 publications

(26 citation statements)

References 33 publications

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“…These criteria differentiate patients with RP caused by lumbar disc herniation from those with lumbar spinal stenosis or nonspecific LBP with leg pain. 30 In this proposal, the presence of an SLRT score of ≤ 60 is a prominent feature. Although the SLRT is widely used for the diagnosis of RP, clinicians should consider this test with caution since it has important limitations.…”

Section: Discussionmentioning

confidence: 99%

Reliability of the Buttock Applied Strain Test to Diagnose Radicular Pain in Patients With Low Back Pain

et al. 2020

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Background: Low-back pain (LBP) pathophysiological conditions include nociceptive back pain, somatic referred pain, radicular pain (RP), and radiculopathy. Differential diagnosis is challenging; guidance may come from patients' thorough clinical history and physical examination and, particularly for lumbar RP, from the evaluation of subjective responses of injured lumbar nerves to a strain applied at the buttock (buttock applied strain [BUAS] test). Methods: In a sample of 395 consecutive patients with LBP, sensitivity, specificity, and prior probability (positive predictive values [PPVs] and negative predictive values [NPVs]) of the BUAS test were evaluated against 2 reference tests: the straight leg raising test (SLRT) and the painDETECT (PD) questionnaire. Multinomial logistic regression (MLR) and v 2 analyses were used to evaluate the BUAS test outcomes' dependence upon independent variables (gender, age group, pain localization, SLRT outcomes, and PD outcomes). Cohen's kappa statistic was used to assess inter-rater agreement. Results: Compared with the PD questionnaire, the BUAS test showed a sensitivity of 92%, specificity of 100%, PPV of 100%, and NPV of 82%; compared with the SLRT, the BUAS test showed a sensitivity of 82%, NPV of 82%, specificity of 40%, and PPV of 40%. Inter-rater agreement of Cohen's kappa was 0.911. Significant associations were found between BUAS test outcomes and pain localization, SLRT outcomes, and PD outcomes, but not with the predictors gender or age group. MLR showed significant congruent relationships between BUAS test and PD outcomes. Conclusion: Among patients with LBP, the BUAS test showed satisfactory sensitivity, specificity, prior probability, and inter-rater reliability; thus, it may be considered a useful adjunctive tool to diagnose RP in patients with LBP. For more generalized results, more research, in clinical settings other than pain clinics, is needed. &

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Section: Discussionmentioning

confidence: 99%

Reliability of the Buttock Applied Strain Test to Diagnose Radicular Pain in Patients With Low Back Pain

et al. 2020

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“…Patients with type IV and V LDH, characterized by serious clinical manifestations, can reach excellent and good outcomes with surgical intervention. In a study performed by Genevay et al, [ 19 ] clinical classification criteria were proposed to identify patients with radicular pain caused by LDH based on a 2-stage process. In stage 1, spine experts participated in a Delphi process to select symptoms and signs suggestive of radicular pain caused by LDH.…”

Section: Discussionmentioning

confidence: 99%

Development and clinical application of grading and classification criteria of lumbar disc herniation

Hao

Duan²,

Liu

et al. 2017

Medicine

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This study aimed to develop new grading and classification criteria for lumbar disc herniation (LDH). First, from January 1993 to January 2003, we collected the detailed information of 1127 patients with LDH and, based on that information, developed a new grading classification termed the 6-score-V-type criteria wherein conservative treatment is recommended for patients with type I, II, or IIIA, surgical treatment is recommended for type IIIC, IV, and V, and 3 months of conservative followed by surgery if no improvements are obtained during the conservative treatment period is recommended for type IIIBe. The distribution of types among the 1,127 patients was: type I (7.9%), type II (22.9%), type III (34.1%), type IV (22.2%), and type V (12.6%). Type III cases were subdivided into type IIIA (9.9%), type IIIB (13.3%), and IIIC (10.8%). Second, from February 2003 to December 2009, we treated a separate group of 1130 patients with LDH according to this 6-score-V-type classification rubric and monitored them for 24 months. Therapeutic efficacy was assessed in 1130 patients with a standard evaluation for leg pain. Overall, 85.3% of the patients in the first year and 84.1% in the second year had good or excellent response ratings. The inter-examiner reliability was 98%. Assignment of therapeutic protocols according to the 6-score-V-type classification yielded satisfactory outcomes, indicating that the 6-score-V-type criteria are straightforward and practical.

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“…shows examination for radiculopathy in those patients where sciatica is suspected. A recent cohort study proposed clinical criteria of unilateral leg pain, monoradicular distribution of pain, positive straight leg raise test at <60° (or femoral stretch test), unilateral motor weakness, and asymmetric ankle reflex to predict sciatica caused by lumbar disc herniation 14…”

Section: How Is Sciatica Diagnosed?mentioning

confidence: 99%

Diagnosis and treatment of sciatica

Jensen

Kongsted

Kjær

et al. 2019

BMJ

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Clinical classification criteria for radicular pain caused by lumbar disc herniation: the radicular pain caused by disc herniation (RAPIDH) criteria

Cited by 30 publications

References 33 publications

Reliability of the Buttock Applied Strain Test to Diagnose Radicular Pain in Patients With Low Back Pain

Reliability of the Buttock Applied Strain Test to Diagnose Radicular Pain in Patients With Low Back Pain

Development and clinical application of grading and classification criteria of lumbar disc herniation

Diagnosis and treatment of sciatica

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