King Abdul Aziz Medical City, Saudi Arabia
Sabah Gaber has graduated from Cairo University, Egypt 1979 with a Bachelor of Science in Physical Therapy. She holds Diploma in Osteopathic Manipulative 2016 and Post-graduate Diploma in Pelvic Rehabilitation 2012. She has attended specific courses as Cyrix, Mc Connell approaches and Women Health. She has started her career from the Arab Contract Medical Center in Egypt and has done her Specialization in Musculoskeletal, especially in the Spine Disorders and Rehabilitation. She played a crucial role in establishing new specialty Women Health Clinic and Education. She has initiated Osteopath in treating her patients.
Introduction: High percentage of out-patients who referred as LBP and radiculopathy were not diagnosed based on MRI or CT scan findings.
Clinical Question: In case of LBP and radiculopathy, are clinical examinations as accurate as MRI and CT scan?
Summary Study Design: Study design of articles retrieved is a diagnostic systemic review and meta-analysis entitled by “Neurological examination of the peripheral nervous system to diagnosis lumbar spinal disc herniation with suspected radiculopathy” published on 8th Feb-2013 N H AL Nezari. The systematic review targeted an important common disorder which is LBP with radiculopathy that may be dangerous if not diagnosed well and treated. The targeted clinical examination is helpful and famous. It is essential in objective evaluation and decision making.
Results: This systemic review includes 14 diagnostic articles; the results are similar from study to study and were combined. Results of each study were presented clearly and in form of forest plot for sensitivities and specificities: 3 on sensory tests; 3 on motor tests (paresis and atrophy); and 2 on reflex testing. Regarding the test of heterogeneity only the diagnostic meta-analysis software, developed by Zamora et al. was mentioned, which was used to pool the results of homogenous studies and it was not mention while using the fixed effects model and the random effects model.
Conclusion: Neurological testing procedures have limited overall diagnostic accuracy. Pooled diagnostic accuracy values of the tests were poor. All tests demonstrated: low sensitivity and moderate specificity. Neurological testing procedures in isolation do not provide an acceptable LR to indicate a disc herniation in patients with suspected radiculopathy.