New physical examination tests for lumbar spondylolisthesis and instability: low midline sill sign and interspinous gap change during lumbar flexion-extension motion

Ahn, Kang-Min; Jhun, Hyung-Joon

doi:10.1186/s12891-015-0551-0

Cited by 27 publications

(33 citation statements)

References 13 publications

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“…The instability is due to the facet joints tending to align closest to the sagittal plane. 35 , 50 Interestingly, the youngest patient with radiological lumbar instability in the present study was 23 years’ old, which was concordant with that of a previous study 7 in which the authors reported that instability started in patients in their 20 s. They suggested that those patients could have been in the initial stage of disk degeneration. 7 …”

Section: Discussionsupporting

confidence: 92%

A Screening Tool for Patients With Lumbar Instability

Chatprem

Puntumetakul

Boucaut

et al. 2020

Spine

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Section: Discussionsupporting

confidence: 92%

A Screening Tool for Patients With Lumbar Instability

Chatprem

Puntumetakul

Boucaut

et al. 2020

Spine

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“…)0.59 (? )Spondylolisthesis Studies supporting a diagnostic rule Manual hypermobility test positive (P) Fritz 2005 [87]0.46 (0.30–0.64)0.81 (0.60–0.92)2.4 (0.9–6.4)0.66 (0.44–0.99) Lack of manual hypomobility test positive (P) Fritz 2005 [87]0.43 (0.27–0.61)0.95 (0.77–0.99)9.0 (1.3–63.9)0.60 (0.43–0.84) Lack of manual hypomobility test positive and flexion ROM > 53° (P) Fritz 2005 [87]0.29 (0.13–0.46)0.98 (0.91–1.00)12.8 (0.8–211.6)0.72 (0.55–0.94) Manual flexion hypermobility test positive (P) rotation Abbott 2005 [88]0.05 (0.01–0.36)0.99 (0.96–1.00)4.1 (0.2–80.3)0.96 (0.83–1.11) Manual flexion hypermobility test positive (P)translation Abbott 2005 [88]0.05 (0.01–0.22)0.99 (0.97–1.00)8.7 (0.6–134.7)0.96 (0.88–1.05) Manual extension hypermobility test positive (P) rotation Abbott 2005 [88]0.22 (0.06–0.55)0.97 (0.94–0.99)8.4 (1.9–37.6)0.80 (0.56–1.13) Manual extension hypermobility test positive (P) translation Abbott 2005 [88]0.16 (0.06–0.38)0.98 (0.94–0.99)7.1 (1.7–29.2)0.86 (0.71–1.05) Slipping by palpation (P) Kalpakcioglu 2009 [90]0.88 (0.80–0.93)1.00 (0.89–1.00)NA0.12 (0.07–0.20) Slipping by palpation (P) Collaer 2006 [91]0.60 (0.15–0.95)0.87 (0.73–0.96)4.7 (1.6–13.9)0.46 (0.16–1.35) Passive lumbar extension test (P) Kasai 2006 [89]0.84 (0.70–0.93)0.90 (0.82–0.95)8.8 (4.5–17.3)0.18 (0.08–0.37) Passive lumbar extension test (P) Ferrari 2014 [92]0.44 (0.29–0.59)0.86 (0.67–0.95)3.2 (1.1–9.7)0.65 (0.47–0.90) Studies not supporting a diagnostic rule None Additional findings reported by more than one study Slipping by inspection (P) Kalpakcioglu 2009 [90]0.21 (0.14–0.30)1.00 (0.89–1.00)NA0.79 (0.71–0.87) Slipping and Sill sign by inspection and palpation (P) Ahn 2015 [93]0.81 (0.65–0.91)...…”

Section: Resultsmentioning

confidence: 99%

Clinical classification in low back pain: best-evidence diagnostic rules based on systematic reviews

Petersen¹,

Laslett²,

Juhl

2017

BMC Musculoskelet Disord

139

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BackgroundClinical examination findings are used in primary care to give an initial diagnosis to patients with low back pain and related leg symptoms. The purpose of this study was to develop best evidence Clinical Diagnostic Rules (CDR] for the identification of the most common patho-anatomical disorders in the lumbar spine; i.e. intervertebral discs, sacroiliac joints, facet joints, bone, muscles, nerve roots, muscles, peripheral nerve tissue, and central nervous system sensitization.MethodsA sensitive electronic search strategy using MEDLINE, EMBASE and CINAHL databases was combined with hand searching and citation tracking to identify eligible studies. Criteria for inclusion were: persons with low back pain with or without related leg symptoms, history or physical examination findings suitable for use in primary care, comparison with acceptable reference standards, and statistical reporting permitting calculation of diagnostic value. Quality assessments were made independently by two reviewers using the Quality Assessment of Diagnostic Accuracy Studies tool. Clinical examination findings that were investigated by at least two studies were included and results that met our predefined threshold of positive likelihood ratio ≥ 2 or negative likelihood ratio ≤ 0.5 were considered for the CDR.ResultsSixty-four studies satisfied our eligible criteria. We were able to construct promising CDRs for symptomatic intervertebral disc, sacroiliac joint, spondylolisthesis, disc herniation with nerve root involvement, and spinal stenosis. Single clinical test appear not to be as useful as clusters of tests that are more closely in line with clinical decision making.ConclusionsThis is the first comprehensive systematic review of diagnostic accuracy studies that evaluate clinical examination findings for their ability to identify the most common patho-anatomical disorders in the lumbar spine. In some diagnostic categories we have sufficient evidence to recommend a CDR. In others, we have only preliminary evidence that needs testing in future studies. Most findings were tested in secondary or tertiary care. Thus, the accuracy of the findings in a primary care setting has yet to be confirmed.Electronic supplementary materialThe online version of this article (doi:10.1186/s12891-017-1549-6) contains supplementary material, which is available to authorized users.

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“…In a study by Ebrahimzadeh et al (1996) in Iran, 13 patients were women and 7 men (12). Kalpakcioglu et al (2009) in one study and Ahnand Jhun (2015) in another one reported that the number of women was higher than men (13,14). The most common type of spondylolisthesis was degenerative (95.2%).…”

Section: Discussionmentioning

confidence: 96%

Investigation of Surgery Characteristics in Patients with Spondylolisthesis, Rasht, Iran from 2006 to 2011

Yousefzadeh-Chabok

Kazemnejad-Leili

Khatami

et al. 2015

IrJNS

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Background & Aim: Spondylolisthesis is a visible deformity in lumbosacral region with vertebral slip and fracture or other deformities of pars interarticularis. This study aims at investigating the characteristics of spondylolisthesis surgery in operated patients. Methods & Materials/Patients: This is a retrospective study which included all the patients who had undergone spondylolisthesis surgery by one same surgeon from 2006 to 2011. Demographic characteristics such as age, gender, and surgery information including type of spondylolisthesis, incision site, laminectomy site, foraminotomy site, fixation site of vertebra and site of vertebral disc evacuation were collected. The data were analyzed using SPSS (Version16). Results: 52 of 63 enrolled patients were women (82.5%) and 11 men (17.5%) with mean age of 49.6 years. Based on frequency, spondylolisthesis types were 60 degenerative (95.2%), 2 post-surgical (3.2%) and 1 post-traumatic (1.6%), respectively. 58 patients had spondylolisthesis only in one vertebra and 5 patients in two vertebrae. The total number of slipped vertebrae was 68, in which slip was seen in L3, L4 or L5 vertebrae. In 42 patients, laminectomy was performed only in one vertebra, in 19 patients in two vertebrae, in 1 patient in three vertebrae and in 1 patient in five vertebrae. The total number of vertebrae with foraminotomy was 106. The highest frequency of foraminotomy was seen in L5, L4, and S1 vertebrae, respectively. Except in one case, the rest 62 patients underwent fixation surgery in two or three vertebrae. Conclusion: Based on the results, the frequency of spondylolisthesis was approximately five times in women compared to men. The most common type was degenerative spondylolisthesis. Type of surgery was fixation with pedicle screw and fusion.

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New physical examination tests for lumbar spondylolisthesis and instability: low midline sill sign and interspinous gap change during lumbar flexion-extension motion

Cited by 27 publications

References 13 publications

A Screening Tool for Patients With Lumbar Instability

A Screening Tool for Patients With Lumbar Instability

Clinical classification in low back pain: best-evidence diagnostic rules based on systematic reviews

Investigation of Surgery Characteristics in Patients with Spondylolisthesis, Rasht, Iran from 2006 to 2011

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