Lemeunier Nadège, da Silva-Oolup S, Chow N, Southerst D, Carroll L, Wong J J, Shearer H, Mastragostino P, Cox J, Côté E, Murnaghan K, Sutton D, Côté P
Institut Franco-Européen de Chiropraxie, 72 chemin de la Flambère, 31300, Toulouse, France.
UOIT-CMCC Centre for the Study of Disability Prevention and Rehabilitation, University of Ontario Institute of Technology (UOIT), 2000 Simcoe St. N., Oshawa, ON, L1H 7K4, Canada.
Eur Spine J. 2017 Sep;26(9):2225-2241. doi: 10.1007/s00586-017-5153-0. Epub 2017 Jun 12.
To determine the reliability and validity of clinical tests to assess the anatomical integrity of the cervical spine in adults with neck pain and its associated disorders.
We updated the systematic review of the 2000-2010 Bone and Joint Decade Task Force on Neck Pain and its Associated Disorders. We also searched the literature to identify studies on the reliability and validity of Doppler velocimetry for the evaluation of cervical arteries. Two independent reviewers screened and critically appraised studies. We conducted a best evidence synthesis of low risk of bias studies and ranked the phases of investigations using the classification proposed by Sackett and Haynes.
We screened 9022 articles and critically appraised 8 studies; all 8 studies had low risk of bias (three reliability and five validity Phase II-III studies). Preliminary evidence suggests that the extension-rotation test may be reliable and has adequate validity to rule out pain arising from facet joints. The evidence suggests variable reliability and preliminary validity for the evaluation of cervical radiculopathy including neurological examination (manual motor testing, dermatomal sensory testing, deep tendon reflexes, and pathological reflex testing), Spurling's and the upper limb neurodynamic tests. No evidence was found for doppler velocimetry.
Little evidence exists to support the use of clinical tests to evaluate the anatomical integrity of the cervical spine in adults with neck pain and its associated disorders. We found preliminary evidence to support the use of the extension-rotation test, neurological examination, Spurling's and the upper limb neurodynamic tests.
确定用于评估颈部疼痛及相关疾病成年患者颈椎解剖结构完整性的临床检查的可靠性和有效性。
我们更新了2000 - 2010年骨与关节十年颈部疼痛及其相关疾病特别工作组的系统评价。我们还检索了文献，以确定关于多普勒测速法评估颈总动脉可靠性和有效性的研究。两名独立的评审员筛选并严格评价了各项研究。我们对低偏倚风险的研究进行了最佳证据综合，并使用Sackett和Haynes提出的分类方法对研究阶段进行了排名。
我们筛选了9022篇文章并严格评价了8项研究；所有8项研究的偏倚风险均较低（3项可靠性研究和5项有效性II - III期研究）。初步证据表明，伸展 - 旋转试验可能具有可靠性，并且在排除小关节疼痛方面具有足够的有效性。有证据表明，包括神经学检查（手动运动测试、皮节感觉测试、深腱反射和病理反射测试）、斯普林试验（Spurling's）和上肢神经动力试验在内的评估神经根型颈椎病的可靠性和初步有效性存在差异。未发现支持多普勒测速法的证据。
几乎没有证据支持使用临床检查来评估颈部疼痛及相关疾病成年患者颈椎的解剖结构完整性。我们发现了初步证据支持使用伸展 - 旋转试验、神经学检查、斯普林试验和上肢神经动力试验。
