Adachi Shu, Nakano Atsushi, Kin Akihiro, Baba Ichiro, Kurokawa Yoshitaka, Neo Masashi
Department of Orthopedic Surgery, Nishinomiyakyoritsu Neurosurgical Hospital, Hyogo, Japan.
Department of Orthopedic Surgery, Osaka Medical College, Osaka, Japan.
Acta Orthop Traumatol Turc. 2018 Jan;52(1):12-16. doi: 10.1016/j.aott.2017.04.007. Epub 2017 Nov 11.
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).
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.
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).
The Tibial Nerve Compression Test is a useful screening tool for LSS diagnosis in a primary care setting.
Level II, diagnostic study.
在本研究中，我们旨在评估“胫神经压迫试验（TNCT）”作为腰椎管狭窄症（LSS）筛查工具的诊断准确性和适用性。
本研究纳入了我院连续收治的108例因手术治疗或诊断LSS入院的患者。选取50名健康志愿者作为对照组进行检查。对压痛程度进行评分（压痛评分）并采用视觉模拟量表进行测量（P-VAS评分）。比较LSS组和对照组之间的这些评分。此外，还对手术患者术前和术后的评分进行了比较。
LSS组的阳性压痛率（92.6%[100/108]）显著高于对照组（30%[15/50]）。TNCT的敏感度和特异度（95%置信区间）分别为0.93（0.88-0.96）和0.70（0.61-0.77）。LSS组的阳性压痛率和P-VAS评分显著更高（p<0.0001）。手术患者术后所有测量指标的评分均显著改善（p<0.0001）。
胫神经压迫试验是基层医疗环境中诊断LSS的一种有用的筛查工具。
二级，诊断性研究。
