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Vol 52, No 1 (2018) Pages : 12- 16

The tibial nerve compression test for the diagnosis of lumbar spinal canal stenosis—A simple and reliable physical examination for use by primary care physicians

Shu ADACHİ, Atsushi NAKANO, Akihiro KİN, Ichiro BABA, Yoshitaka KUROKAWA, Masashi NEO

Abstract
Objectives
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).
Methods
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.
Results
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).
Conclusion
The Tibial Nerve Compression Test is a useful screening tool for LSS diagnosis in a primary care setting.
Level of evidence
Level II, diagnostic study
ER -

Keywords

  • Tibial nerve compression test
  • Lumbar spinal canal stenosis
  • Diagnostic accuracy
  • Visual analog scale
  • Clinical examination test