Diagnostic accuracy of patient interview items and clinical tests for cervical radiculopathy

Sleijser-Koehorst, Marije L. S.; Coppieters, Michel W.; Epping, R.; Rooker, Servan; Verhagen, Arianne P.; Scholten-Peeters, Gwendolyne G M

doi:10.1016/j.physio.2020.07.007

Cited by 18 publications

(30 citation statements)

References 35 publications

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“…Although there has been sparse literature in reference to cervical TFESI, it suggests benefits for neck pain or/and radicular pain caused by a cervical herniated disc and non-traumatic spondylosis. Consistent with the above studies, in the present study, the median of NRS scores in the FL group was significantly lower than the baseline value [ 7 ] at 1 month [ 3 ], 3 months [ 2 ], and 6 months (0) (all p < .001). The median of NDI scores decreased significantly from 70.5 at baseline to 35.0 at 1 month, 19.5 at 3 months and 0.0 at 6 months after FL-guided TFESI via an anterolateral approach (all p < .001).…”

Section: Discussionsupporting

confidence: 91%

“…A large epidemiological study applied wide criteria encompassing neck and arm pain which was proved by corresponding MRI findings and estimated that the yearly prevalence peaked in the fourth and fifth decades [ 2 ]. Radiculopathy refers to both radicular pain and radiculopathy that can occur due to nerve root compression by disc herniation, spondylosis or a combination of both disorders [ 3 ]. C5–C7 are the most commonly affected levels usually with common sensory symptoms of unilateral dermatomal tingling or numbness and less common motor symptoms [ 4 ].…”

Section: Introductionmentioning

confidence: 99%

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An open-label non-inferiority randomized trail comparing the effectiveness and safety of ultrasound-guided selective cervical nerve root block and fluoroscopy-guided cervical transforaminal epidural block for cervical radiculopathy

Cui¹,

Zhang²,

Zhao

et al. 2022

Annals of Medicine

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Object To compare therapeutic efficacy and safety of ultrasound (US)-guided selective nerve root block (SNRB) and fluoroscopy (FL)-guided transforaminal epidural steroid injection (TFESI) for cervical spine radiculopathy (CSR). Method 156 patients with CSR randomly received US-guided SNRB verified by FL or FL-guided TFESI. We hypothesised that the accuracy rate of contrast dispersion into epidural or intervertebral foraminal space in the US group was not inferior to that in the FL group with a margin of clinical unimportance of −15%. Pain intensity assessed by Numeric Rating Scales (NRS) and functional disability estimated by neck disability index (NDI) were compared before treatment, at 1, 3 and 6 months after the intervention. Puncture time and complication frequencies were also reported. Results 88.7% and 90.3% accuracy ratings were respectively achieved in the US and FL groups with a treatment difference of −1.6% (95%CI: −9.7%, 6.6%) revealing that the lower limit was above the non-inferiority margin. Both NRS and NDI scores illustrated improvements at 1, 3 and 6 months after intervention with no statistically significant differences between the two groups (all p > .05). Additionally, shorter administration duration was observed in the US group ( p < .001). No severe complications were observed in both group. Conclusion Compared with the FL group, the US group provided a non-inferior accuracy rate of epidural/foraminal contrast pattern. For the treatment of CSR, the US technique provided similar pain relief and functional improvements while facilitating distinguishing critical vessels adjacent to the foramen and requiring a shorter procedure duration without exposure to radiation. Therefore, it was an attractive alternative to the conventional FL method. Key messages We conducted a prospective, open-label, randomised and non-inferiority clinical trial to estimate a hypothesis that the precisely accurate delivery through ultrasound (US)-guided cervical selective nerve root block (SNRB) was non-inferior to that using FL-guided transforaminal epidural steroid injection. Additionally, US-guided SNRB was as effective as FL-guided TFESI in the treatment effect on pain relief and function improvements. Notably, the US technique might be an alternative to the conventional FL method due to the ability to prevent inadvertent vascular puncture (VP) and intravascular injection (IVI) with a shorter administration time and absence of radiation exposure.

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Section: Discussionsupporting

confidence: 91%

Section: Introductionmentioning

confidence: 99%

An open-label non-inferiority randomized trail comparing the effectiveness and safety of ultrasound-guided selective cervical nerve root block and fluoroscopy-guided cervical transforaminal epidural block for cervical radiculopathy

Cui¹,

Zhang²,

Zhao

et al. 2022

Annals of Medicine

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“…Some authors proposed that the sensitivity of Spurling’s test varied from moderate to high while its specificity was high. 12 , 30 …”

Section: Discussionmentioning

confidence: 99%

“…Some authors proposed that the sensitivity of Spurling's test varied from moderate to high while its specificity was high. 12,30 Cervical spondylotic amyotrophy is characterized by upper limb muscle weakness and atrophy without sensory deficits. [31][32][33] In this study, among 106 patients with cervical spondylosis, muscle weakness, atrophy, and absence of hypoesthesia in the upper extremities were observed in 15 patients.…”

mentioning

confidence: 99%

Description of Clinical Features and Diagnoses of 444 Cases with Neck-Shoulder-Upper Extremity Pain: A Single-Center Retrospective Review

Zhang¹,

Luo²,

Li³

et al. 2022

JPR

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Purpose Neck-shoulder-upper extremity pain (NSUEP) is a frequently occurring clinical constellation of syndromes. However, its etiology is complicated, and the diagnosis is challenging. We aimed to present detailed clinical characteristics and diagnoses of NSUEP from a single center and heighten clinicians’ understanding of this condition. Patients and Methods Prospectively collected databases were used to retrospectively evaluate patients with NSUEP who underwent treatment at the multidisciplinary consultation center for neck, shoulder, and upper extremity pain at the China-Japan Union Hospital of Jilin University between April 2014 and July 2021. We performed descriptive statistics regarding demographic data, symptoms, findings of physical and radiographic examinations, and each patient’s diagnosis. Results Development of NSUEP was primarily observed in individuals aged between 51 and 60 years (n = 157, 35.4%). Patients were most commonly referred for upper extremity pain (n = 306, 68.9%). Patients with upper extremity pain presented with hypoesthesia (n = 139, 45.4%), muscle weakness (n = 93, 30.4%), muscle atrophy (n = 90, 29.4%), hyperesthesia (n = 39, 12.7%), and turgidity (n = 18, 5.9%). Among the 22 patients with upper extremity swelling, 8 (36.4%) were diagnosed with autoimmune rheumatic diseases. Among the 352 patients with a single diagnosis, 51 (14.5%) presented with thoracic outlet syndrome, 49 (13.9%) with cervical radiculopathy, 16 (4.5%) with carpal tunnel syndrome, and 16 (4.5%) with brachial plexus injury. Further, among the 92 patients with compound diagnosis, 18 patients (19.6%) were diagnosed with cervical radiculopathy. Conclusion Among the NSUEP patients in this study, older individuals were the largest group. Pain, numbness, weakness, and mobility limitation are common complaints accompanying NSUEP. The common etiologies of NSUEP include cervical spondylosis, thoracic outlet syndrome, carpal tunnel syndrome, and brachial plexus injury. In addition, autoimmune rheumatic diseases should be considered in patients with NSUEP and swelling.

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“…This will give the midwife room to think that the examination having to be done in step three "Examine the client" should be an examination that focuses on reaching an accurate conclusion. Conformity between the results of the anamnesis and examination and diagnosis is also an important part in other fields such as that of a study by Sleijser-Koehorst, et.,al. (2020).…”

Section: A the Explanation Of The Nine Steps Of Jm Methamentioning

confidence: 99%

Reconstructing the Thinking Process of Midwifery Care Management: An Addie Study

Metha¹,

Oktalia

Desristanto

2021

wmm

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Background: Midwifery management process has been used as a guideline in clinical learning in midwifery. However, the management process that is used until currently has still been literally adopted from foreign sources which are not necessarily compatible with the understanding of most student midwives in Indonesia. Purpose: this ADDIE study was therefore intended to formulate steps in the thinking process of clinical midwifery care. From this series of research steps, Nine Steps of J.M. Metha had been successfully composed. Methods:This ADDIE (Analyze, Design, Develop, Implement, Evaluate) study was to formulate a clinical management mindset in midwifery. In the ‘develop’ section, R&D was used to create a product that could be used, for example, in the clinical learning of student midwives. In the ‘implement’ part, snow-ball sampling was used to extract the same anticipated data from the increasing number of participants. Finally, through FGD, participants’ opinions, which were selected from 3 people because of data saturation, were analyzed using a phenomenological approach to see the phenomena that existed in the use of the created products. Results: The Nine Steps of J.M. Metha were formulated, i.e., See who comes, Listen to the client, Examine the client, Asses the client’s condition, Inform the client about their condition, Plan actions for care, Implement care having planned, Evaluate the care having implemented, and Return to number 1. Based on the opinions of the respondents, these nine steps had already resembled the real midwifery sequences in daily practices. It is then necessary to disseminate this simple, easy to apply midwifery thinking process for the sake of better quality of student midwives and midwifery practitioners. Conclusion: These Nine Steps of J.M. Metha is likely to be suitable for use on the thinking process for midwifery care measures. A further study is therefore recommended with a larger scope of place and participants.

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Diagnostic accuracy of patient interview items and clinical tests for cervical radiculopathy

Cited by 18 publications

References 35 publications

An open-label non-inferiority randomized trail comparing the effectiveness and safety of ultrasound-guided selective cervical nerve root block and fluoroscopy-guided cervical transforaminal epidural block for cervical radiculopathy

An open-label non-inferiority randomized trail comparing the effectiveness and safety of ultrasound-guided selective cervical nerve root block and fluoroscopy-guided cervical transforaminal epidural block for cervical radiculopathy

Description of Clinical Features and Diagnoses of 444 Cases with Neck-Shoulder-Upper Extremity Pain: A Single-Center Retrospective Review

Reconstructing the Thinking Process of Midwifery Care Management: An Addie Study

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