Shah K Chhanalal, Rajshekhar V
Department of Neurological Sciences, Christian Medical College Hospital, Vellore, India.
Br J Neurosurg. 2004 Oct;18(5):480-3. doi: 10.1080/02688690400012350.
The purpose of this study was to determine the sensitivity and specificity of the Spurling's test in predicting the diagnosis of a soft lateral cervical disc prolapse. A prospective study was performed involving 50 patients with neck and arm pain; of these, 25 patients were managed surgically (Group 1) and the other 25 patients were managed conservatively (Group 2). A Spurling's test was performed in all patients and scored as positive or negative. In patients in Group 1, the operative findings were recorded as a soft or hard disc prolapse (osteophyte). In Group 2 patients, the MR findings were recorded as positive for a soft disc prolapse or negative (no disc prolapse or osteophyte only). The results of the Spurling's test were compared with the surgical or MR findings, which were considered as the gold standard. Spurling's test had a sensitivity of 92% and specificity of 95% with positive predictive value (PPV) of 96.4% and negative predictive value (NPV) of 90.9% in predicting a diagnosis of a soft lateral cervical disc prolapse. The high positive predictive value of the test can be utilized to improve the yield of positive MR examinations in patients with cervical radiculopathy.
本研究的目的是确定斯普林试验在预测软性外侧颈椎间盘突出症诊断方面的敏感性和特异性。进行了一项前瞻性研究，纳入50例有颈部和手臂疼痛的患者；其中，25例患者接受手术治疗（第1组），另外25例患者接受保守治疗（第2组）。对所有患者进行了斯普林试验，并将结果记为阳性或阴性。在第1组患者中，手术结果记录为软性或硬性椎间盘突出（骨赘）。在第2组患者中，磁共振成像（MR）结果记录为软性椎间盘突出阳性或阴性（无椎间盘突出或仅有骨赘）。将斯普林试验的结果与被视为金标准的手术或MR结果进行比较。在预测软性外侧颈椎间盘突出症的诊断时，斯普林试验的敏感性为92%，特异性为95%，阳性预测值（PPV）为96.4%，阴性预测值（NPV）为90.9%。该试验较高的阳性预测值可用于提高神经根型颈椎病患者MR检查阳性结果的检出率。
