Neurological examination for cervical radiculopathy: a scoping review
Abstract Background To diagnose cervical radiculopathy according to the International Association for the Study of Pain definition, signs of neurological deficits must be examined with the neurological examination. However, the diagnostic accuracy of the standard neurological examination remains unc...
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BMC
2025-04-01
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| Series: | BMC Musculoskeletal Disorders |
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| Online Access: | https://doi.org/10.1186/s12891-025-08560-9 |
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| author | Marzia Stella Yousif Giuseppe Occhipinti Filippo Bianchini Daniel Feller Annina B. Schmid Firas Mourad |
| author_facet | Marzia Stella Yousif Giuseppe Occhipinti Filippo Bianchini Daniel Feller Annina B. Schmid Firas Mourad |
| author_sort | Marzia Stella Yousif |
| collection | DOAJ |
| description | Abstract Background To diagnose cervical radiculopathy according to the International Association for the Study of Pain definition, signs of neurological deficits must be examined with the neurological examination. However, the diagnostic accuracy of the standard neurological examination remains unclear, and no clear recommendations exist about standard components. Therefore, the objectives of this review are to map the research about the diagnostic accuracy, components, and performance of the neurological examination for cervical radiculopathy. Method PubMed, Embase, Scopus, Cinhal, DiTA databases were searched up to February 23rd, 2024. Additional studies were identified through screening reference lists of the included studies. Studies on neurological examination procedures and their diagnostic accuracy for cervical radiculopathy were included. Results From an initial 12,365 records, 6 articles met the inclusion criteria. All articles were cross-sectional studies and compared the neurological examination with electrodiagnostic tests or magnetic resonance imaging. Reduced tendon reflexes were found to be most specific (81% (95% CI 69–89%) to 99% (95% CI not reported)), while somatosensation testing was least sensitive (25% (95% CI 12–38%; -LR 0.84) to 52% (95% CI 30–74%)). Taking all components into account resulted in higher specificity (98% (95% CI not reported) to 99% (95% CI 95–100%)) but lower sensitivity (7% (95% CI not reported) to 14% (95% CI 5–16%)) compared to electrodiagnostic tests. Conclusions We found varying operational definitions of radiculopathy, suboptimal reference standards, and great heterogeneity in the neurological examination procedure and its diagnostic accuracy. Future research should address these issues to establish the clinical utility of the neurological examination for cervical radiculopathy. Protocol https://doi.org/10.1101/2023.05.22.23290194 . |
| format | Article |
| id | doaj-art-7cdc2cabcf6142e5b64fc4730f3c4521 |
| institution | DOAJ |
| issn | 1471-2474 |
| language | English |
| publishDate | 2025-04-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Musculoskeletal Disorders |
| spelling | doaj-art-7cdc2cabcf6142e5b64fc4730f3c45212025-08-20T03:08:01ZengBMCBMC Musculoskeletal Disorders1471-24742025-04-0126111310.1186/s12891-025-08560-9Neurological examination for cervical radiculopathy: a scoping reviewMarzia Stella Yousif0Giuseppe Occhipinti1Filippo Bianchini2Daniel Feller3Annina B. Schmid4Firas Mourad5Faculty of Medicine and Surgery, Department of Clinical Sciences and Translation Medicine, University of Rome Tor VergataPhysiotherapist Unit, H.T. ClinicOccupational Therapy and Ergonomics Unit, Istituti Clinici Scientifici Maugeri IRCCSProvincial Agency for Health of the Autonomous Province of TrentoNuffield Department of Clinical Neurosciences, Oxford UniversityDepartment of Health, LUNEX University of Applied SciencesAbstract Background To diagnose cervical radiculopathy according to the International Association for the Study of Pain definition, signs of neurological deficits must be examined with the neurological examination. However, the diagnostic accuracy of the standard neurological examination remains unclear, and no clear recommendations exist about standard components. Therefore, the objectives of this review are to map the research about the diagnostic accuracy, components, and performance of the neurological examination for cervical radiculopathy. Method PubMed, Embase, Scopus, Cinhal, DiTA databases were searched up to February 23rd, 2024. Additional studies were identified through screening reference lists of the included studies. Studies on neurological examination procedures and their diagnostic accuracy for cervical radiculopathy were included. Results From an initial 12,365 records, 6 articles met the inclusion criteria. All articles were cross-sectional studies and compared the neurological examination with electrodiagnostic tests or magnetic resonance imaging. Reduced tendon reflexes were found to be most specific (81% (95% CI 69–89%) to 99% (95% CI not reported)), while somatosensation testing was least sensitive (25% (95% CI 12–38%; -LR 0.84) to 52% (95% CI 30–74%)). Taking all components into account resulted in higher specificity (98% (95% CI not reported) to 99% (95% CI 95–100%)) but lower sensitivity (7% (95% CI not reported) to 14% (95% CI 5–16%)) compared to electrodiagnostic tests. Conclusions We found varying operational definitions of radiculopathy, suboptimal reference standards, and great heterogeneity in the neurological examination procedure and its diagnostic accuracy. Future research should address these issues to establish the clinical utility of the neurological examination for cervical radiculopathy. Protocol https://doi.org/10.1101/2023.05.22.23290194 .https://doi.org/10.1186/s12891-025-08560-9DermatomesMyotomesReflexEntrapment neuropathyNeck painNeurological examination |
| spellingShingle | Marzia Stella Yousif Giuseppe Occhipinti Filippo Bianchini Daniel Feller Annina B. Schmid Firas Mourad Neurological examination for cervical radiculopathy: a scoping review BMC Musculoskeletal Disorders Dermatomes Myotomes Reflex Entrapment neuropathy Neck pain Neurological examination |
| title | Neurological examination for cervical radiculopathy: a scoping review |
| title_full | Neurological examination for cervical radiculopathy: a scoping review |
| title_fullStr | Neurological examination for cervical radiculopathy: a scoping review |
| title_full_unstemmed | Neurological examination for cervical radiculopathy: a scoping review |
| title_short | Neurological examination for cervical radiculopathy: a scoping review |
| title_sort | neurological examination for cervical radiculopathy a scoping review |
| topic | Dermatomes Myotomes Reflex Entrapment neuropathy Neck pain Neurological examination |
| url | https://doi.org/10.1186/s12891-025-08560-9 |
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