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Acta Orthop Traumatol Turc. 2018 Jan;52(1):12-16. doi: 10.1016/j.aott.2017.04.007. Epub 2017 Nov 11.

The tibial nerve compression test for the diagnosis of lumbar spinal canal stenosis-A simple and reliable physical examination for use by primary care physicians.

Author information

1
Department of Orthopedic Surgery, Nishinomiyakyoritsu Neurosurgical Hospital, Hyogo, Japan. Electronic address: adachi5412@gmail.com.
2
Department of Orthopedic Surgery, Osaka Medical College, Osaka, Japan.
3
Department of Orthopedic Surgery, Osaka Medical College Mishima-Minami Hospital, Osaka, Japan.
4
Department of Orthopedic Surgery, Sato Hospital, Osaka, Japan.

Abstract

OBJECTIVES:

In the present study, we aimed to evaluate the diagnostic accuracy and suitability of the 'Tibial Nerve Compression Test (TNCT)' as a screening tool for lumbar spinal canal stenosis (LSS).

METHODS:

A total of 108 consecutive patients admitted to our hospital for surgical treatment or diagnosis of LSS were included in this study. Fifty healthy volunteers were examined as a control group. The severity of tenderness was scored (tenderness score) and measured on a visual analogue scale (P-VAS score). These scores were compared between the LSS and control groups. Moreover, they were compared before and after the operation among operated patients.

RESULTS:

The positive tenderness rate was significantly higher (92.6% [100/108]) in the LSS group than in the control group (30% [15/50]). The sensitivity and specificity of TNCT (95% confidence interval) were 0.93 (0.88-0.96) and 0.70 (0.61-0.77), respectively. Positive tenderness rates and P-VAS scores were significantly higher in the LSS group (p < 0.0001). Scores on all measures significantly improved post-operatively in operated patients (p < 0.0001).

CONCLUSION:

The Tibial Nerve Compression Test is a useful screening tool for LSS diagnosis in a primary care setting.

LEVEL OF EVIDENCE:

Level II, diagnostic study.

KEYWORDS:

Clinical examination test; Diagnostic accuracy; Lumbar spinal canal stenosis; Tibial nerve compression test; Visual analog scale

PMID:
29137932
DOI:
10.1016/j.aott.2017.04.007
[Indexed for MEDLINE]
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