Yoshitaka KUROKAWA, Masashi NEO, Ichiro BABA, Akihiro KİN, Atsushi NAKANO, Shu ADACHİA

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

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 diagnosisof LSS were included in this study. Fifty healthy volunteers were examined as a control group. Theseverity of tenderness was scored (tenderness score) and measured on a visual analogue scale (P-VASscore). These scores were compared between the LSS and control groups. Moreover, they were comparedbefore and after the operation among operated patients.Results: The positive tenderness rate was signiŞcantly higher (92.6% [100/108]) in the LSS group than inthe control group (30% [15/50]). The sensitivity and speciŞcity of TNCT (95% conŞdence interval) were0.93 (0.88e0.96) and 0.70 (0.61e0.77), respectively. Positive tenderness rates and P-VAS scores weresigniŞcantly higher in the LSS group (p < 0.0001). Scores on all measures signiŞcantly improved postoperatively in operated patients (p< 0.0001).Conclusion: The Tibial Nerve Compression Test is a useful screening tool for LSS diagnosis in a primarycare setting.Level of evidence: Level II, diagnostic study© 2017 Turkish Association of Orthopaedics and Traumatology. Publishing services by Elsevier B.V. This isan open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

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