Department of Spinal Surgery, Affiliated Baoan Hospital of Shenzhen, Southern Medical University, No.118 , Longjing Two Road , Xinan Street, Shenzhen, 518101, People's Republic of China.
Neuroradiology. 2019 Oct;61(10):1111-1121. doi: 10.1007/s00234-019-02248-3. Epub 2019 Jul 30.
This meta-analysis intends to use all available evidence to clarify the diagnostic performance of the nerve root sedimentation sign (NRSS).
The PubMed, EMBASE, the Cochrane Library database, China knowledge Infrastructure Project (CNKI), and Wanfang Database were searched up to January 2019 for relevant original studies. Data were extracted to calculate the pooled sensitivity, specificity, diagnostic odds ratio (DOR), positive and negative likelihood ratios (PLR and NLR), and areas under summary receiver operating characteristic curve (SROC) for analysis. The clinical applicability was evaluated with a Fagan's plot and likelihood ratio dot diagram. Deek's funnel plot was used to assess publication bias.
A total of 14 studies including 1333 positive cases and 2658 negative controls were available for the meta-analysis. The pooled sensitivity and specificity of the NRSS for the diagnosis of LSS was 0.84 (95% CI 0.75, 0.91) and 0.95 (95% CI 0.81, 0.99), respectively. The PLR was 18.6 (95% CI 4.0, 86.8), the NLR was 0.17 (95% CI 0.10, 0.28), and the DOR was 112 (95% CI 17,741). The SROC value was 0.93 (95% CI 0.91, 0.95). The Fagan's plot showed that the pre-test probability was 50% and the post-test probability was 95%. The likelihood ratio dot graph showed that the combined effect of the diagnosis fell on the right upper quadrant. Deek's funnel found no publication bias.
NRSS has high diagnostic sensitivity, specificity, and efficacy, and good clinical application value for the diagnosis of LSS. It can be recommended as an auxiliary tool for diagnosis and screening in clinical practice.
本荟萃分析旨在利用所有现有证据阐明神经根沉降征（NRSS）的诊断性能。
检索PubMed、EMBASE、Cochrane 图书馆数据库、中国知识基础设施项目（CNKI）和万方数据库，查找截至 2019 年 1 月的相关原始研究。提取数据以计算汇总敏感性、特异性、诊断比值比（DOR）、阳性和阴性似然比（PLR 和 NLR）以及汇总受试者工作特征曲线（SROC）下面积进行分析。通过 Fagan 图和似然比点图评估临床适用性。Deek 漏斗图用于评估发表偏倚。
共有 14 项研究，包括 1333 例阳性病例和 2658 例阴性对照，可用于荟萃分析。NRSS 诊断 LSS 的汇总敏感性和特异性分别为 0.84（95%置信区间 0.75，0.91）和 0.95（95%置信区间 0.81，0.99）。PLR 为 18.6（95%置信区间 4.0，86.8），NLR 为 0.17（95%置信区间 0.10，0.28），DOR 为 112（95%置信区间 17，741）。SROC 值为 0.93（95%置信区间 0.91，0.95）。Fagan 图显示，术前概率为 50%，术后概率为 95%。似然比点图显示，诊断的综合效应落在右上象限。Deek 漏斗未发现发表偏倚。
NRSS 对 LSS 的诊断具有较高的敏感性、特异性和疗效，具有良好的临床应用价值。可推荐作为临床诊断和筛查的辅助工具。
