Lack of uniform diagnostic criteria for cervical radiculopathy in conservative intervention studies: a systematic review

Erik J Thoomes, Gwendolijne G M Scholten-Peeters, Alice J de Boer, Remy A Olsthoorn, Karin Verkerk, Christine Lin, Arianne P Verhagen

Research output: Contribution to JournalArticleAcademicpeer-review

Abstract

PURPOSE: Cervical radiculopathy (CR) is a common diagnosis. It is unclear if intervention studies use uniform definitions and criteria for patient selection. Our objective was to assess the uniformity of diagnostic criteria and definitions used in intervention studies to select patients with CR.

METHODS: We electronically searched the Cochrane Controlled Trials Register, MEDLINE, EMBASE and CINAHL. Studies were included when evaluating conservative interventions in randomised clinical trials (RCTs) in patients with CR. Selection criteria and definitions for patients with CR were extracted and evaluated on their uniformity.

RESULTS: Thirteen RCTs were included. Pain was used as an inclusion criterion in 11 studies. Inclusion based on the duration and location of pain varied between studies. Five studies used sensory symptoms in the arm as inclusion criterion. Four studies used cervical range of motion and motor disturbances as inclusion criteria, while reflex changes were used in two studies. Three studies included patients with a positive Spurling's test and two studies used it within a cluster of provocation tests.

CONCLUSIONS: Criteria used to select patients with CR vary widely between different intervention studies. Selection criteria and test methods used are poorly described. There is consensus on the presence of pain, but not on the exact location of pain.

Original languageEnglish
Pages (from-to)1459-1470
Number of pages12
JournalEuropean Spine Journal
Volume21
Issue number8
DOIs
Publication statusPublished - Aug 2012

Fingerprint

Radiculopathy
Patient Selection
Pain
Randomized Controlled Trials
Articular Range of Motion
MEDLINE
Reflex
Consensus

Keywords

  • Humans
  • Patient Selection
  • Radiculopathy
  • Randomized Controlled Trials as Topic
  • Journal Article
  • Review

Cite this

Thoomes, Erik J ; Scholten-Peeters, Gwendolijne G M ; de Boer, Alice J ; Olsthoorn, Remy A ; Verkerk, Karin ; Lin, Christine ; Verhagen, Arianne P. / Lack of uniform diagnostic criteria for cervical radiculopathy in conservative intervention studies: a systematic review. In: European Spine Journal. 2012 ; Vol. 21, No. 8. pp. 1459-1470.
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Lack of uniform diagnostic criteria for cervical radiculopathy in conservative intervention studies: a systematic review. / Thoomes, Erik J; Scholten-Peeters, Gwendolijne G M; de Boer, Alice J; Olsthoorn, Remy A; Verkerk, Karin; Lin, Christine; Verhagen, Arianne P.

In: European Spine Journal, Vol. 21, No. 8, 08.2012, p. 1459-1470.

Research output: Contribution to JournalArticleAcademicpeer-review

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N2 - PURPOSE: Cervical radiculopathy (CR) is a common diagnosis. It is unclear if intervention studies use uniform definitions and criteria for patient selection. Our objective was to assess the uniformity of diagnostic criteria and definitions used in intervention studies to select patients with CR.METHODS: We electronically searched the Cochrane Controlled Trials Register, MEDLINE, EMBASE and CINAHL. Studies were included when evaluating conservative interventions in randomised clinical trials (RCTs) in patients with CR. Selection criteria and definitions for patients with CR were extracted and evaluated on their uniformity.RESULTS: Thirteen RCTs were included. Pain was used as an inclusion criterion in 11 studies. Inclusion based on the duration and location of pain varied between studies. Five studies used sensory symptoms in the arm as inclusion criterion. Four studies used cervical range of motion and motor disturbances as inclusion criteria, while reflex changes were used in two studies. Three studies included patients with a positive Spurling's test and two studies used it within a cluster of provocation tests.CONCLUSIONS: Criteria used to select patients with CR vary widely between different intervention studies. Selection criteria and test methods used are poorly described. There is consensus on the presence of pain, but not on the exact location of pain.

AB - PURPOSE: Cervical radiculopathy (CR) is a common diagnosis. It is unclear if intervention studies use uniform definitions and criteria for patient selection. Our objective was to assess the uniformity of diagnostic criteria and definitions used in intervention studies to select patients with CR.METHODS: We electronically searched the Cochrane Controlled Trials Register, MEDLINE, EMBASE and CINAHL. Studies were included when evaluating conservative interventions in randomised clinical trials (RCTs) in patients with CR. Selection criteria and definitions for patients with CR were extracted and evaluated on their uniformity.RESULTS: Thirteen RCTs were included. Pain was used as an inclusion criterion in 11 studies. Inclusion based on the duration and location of pain varied between studies. Five studies used sensory symptoms in the arm as inclusion criterion. Four studies used cervical range of motion and motor disturbances as inclusion criteria, while reflex changes were used in two studies. Three studies included patients with a positive Spurling's test and two studies used it within a cluster of provocation tests.CONCLUSIONS: Criteria used to select patients with CR vary widely between different intervention studies. Selection criteria and test methods used are poorly described. There is consensus on the presence of pain, but not on the exact location of pain.

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