VALIDATION OF A NEW CLINICAL SIGN OF LUMBAR FACET SYNDROME
Autor(a) principal: | |
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Data de Publicação: | 2018 |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Coluna/Columna |
Texto Completo: | http://old.scielo.br/scielo.php?script=sci_arttext&pid=S1808-18512018000400303 |
Resumo: | ABSTRACT Objective: Facet joints are true synovial joints, which derive their nerve supply from the sinuvertebral or recurrent nerve of Luschka as well as the posterior primary division of the corresponding spinal nerve. Diagnosis of low-back pain originating in the facet joints is difficult, and has traditionally relied upon invasive tests. To aid in the clinical diagnosis of this condition, the senior author described a new clinical sign. The following research project was designed to test the utility of this sign in the diagnosis of lumbar facet joint pain. Methods: We conducted a prospective evaluation of patients suspected of having low back pain secondary to facet joint involvement (Lumbar Facet joint Pain Syndrome – LFPS) during a twelve month observation period; candidate patients were evaluated clinically using the new diagnostic sign, which was then compared to findings on radionuclide bone scans and diagnostic medial branch blocks. Contingency table analysis was performed to calculate the sensitivity, specificity, positive and negative predictive values and accuracy of the new clinical sign. Results: Contingency table analysis showed the following operating characteristics for the new diagnostic sign: Sensitivity: 70.37%, Specificity: 50%, Positive predictive value: 90.47%, Negative predictive value: 20% and accuracy 67.7%. Conclusions: Although the new clinical sign failed to show the same operating characteristics as the ones originally described, it has high sensitivity coupled with a good positive predictive value. We consider that although the sign by itself is not diagnostic of lumbar facet joint pain, its presence should alert the clinician to the diagnosis and the possibility of requiring additional testing. Level of Evidence III; Case control studyg. |
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VALIDATION OF A NEW CLINICAL SIGN OF LUMBAR FACET SYNDROMEPainBack painZygapophyseal jointDiagnosisLow back painABSTRACT Objective: Facet joints are true synovial joints, which derive their nerve supply from the sinuvertebral or recurrent nerve of Luschka as well as the posterior primary division of the corresponding spinal nerve. Diagnosis of low-back pain originating in the facet joints is difficult, and has traditionally relied upon invasive tests. To aid in the clinical diagnosis of this condition, the senior author described a new clinical sign. The following research project was designed to test the utility of this sign in the diagnosis of lumbar facet joint pain. Methods: We conducted a prospective evaluation of patients suspected of having low back pain secondary to facet joint involvement (Lumbar Facet joint Pain Syndrome – LFPS) during a twelve month observation period; candidate patients were evaluated clinically using the new diagnostic sign, which was then compared to findings on radionuclide bone scans and diagnostic medial branch blocks. Contingency table analysis was performed to calculate the sensitivity, specificity, positive and negative predictive values and accuracy of the new clinical sign. Results: Contingency table analysis showed the following operating characteristics for the new diagnostic sign: Sensitivity: 70.37%, Specificity: 50%, Positive predictive value: 90.47%, Negative predictive value: 20% and accuracy 67.7%. Conclusions: Although the new clinical sign failed to show the same operating characteristics as the ones originally described, it has high sensitivity coupled with a good positive predictive value. We consider that although the sign by itself is not diagnostic of lumbar facet joint pain, its presence should alert the clinician to the diagnosis and the possibility of requiring additional testing. Level of Evidence III; Case control studyg.Sociedade Brasileira de Coluna2018-12-01info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersiontext/htmlhttp://old.scielo.br/scielo.php?script=sci_arttext&pid=S1808-18512018000400303Coluna/Columna v.17 n.4 2018reponame:Coluna/Columnainstname:Sociedade Brasileira de Coluna (SBCO)instacron:SBCO10.1590/s1808-185120181704160077info:eu-repo/semantics/openAccessGonzalez,Juan Carlos Acevedoeng2018-12-07T00:00:00Zoai:scielo:S1808-18512018000400303Revistahttps://www.revistacoluna.org/ONGhttps://old.scielo.br/oai/scielo-oai.phpcoluna.columna@uol.com.br||revistacoluna@uol.com.br2177-014X1808-1851opendoar:2018-12-07T00:00Coluna/Columna - Sociedade Brasileira de Coluna (SBCO)false |
dc.title.none.fl_str_mv |
VALIDATION OF A NEW CLINICAL SIGN OF LUMBAR FACET SYNDROME |
title |
VALIDATION OF A NEW CLINICAL SIGN OF LUMBAR FACET SYNDROME |
spellingShingle |
VALIDATION OF A NEW CLINICAL SIGN OF LUMBAR FACET SYNDROME Gonzalez,Juan Carlos Acevedo Pain Back pain Zygapophyseal joint Diagnosis Low back pain |
title_short |
VALIDATION OF A NEW CLINICAL SIGN OF LUMBAR FACET SYNDROME |
title_full |
VALIDATION OF A NEW CLINICAL SIGN OF LUMBAR FACET SYNDROME |
title_fullStr |
VALIDATION OF A NEW CLINICAL SIGN OF LUMBAR FACET SYNDROME |
title_full_unstemmed |
VALIDATION OF A NEW CLINICAL SIGN OF LUMBAR FACET SYNDROME |
title_sort |
VALIDATION OF A NEW CLINICAL SIGN OF LUMBAR FACET SYNDROME |
author |
Gonzalez,Juan Carlos Acevedo |
author_facet |
Gonzalez,Juan Carlos Acevedo |
author_role |
author |
dc.contributor.author.fl_str_mv |
Gonzalez,Juan Carlos Acevedo |
dc.subject.por.fl_str_mv |
Pain Back pain Zygapophyseal joint Diagnosis Low back pain |
topic |
Pain Back pain Zygapophyseal joint Diagnosis Low back pain |
description |
ABSTRACT Objective: Facet joints are true synovial joints, which derive their nerve supply from the sinuvertebral or recurrent nerve of Luschka as well as the posterior primary division of the corresponding spinal nerve. Diagnosis of low-back pain originating in the facet joints is difficult, and has traditionally relied upon invasive tests. To aid in the clinical diagnosis of this condition, the senior author described a new clinical sign. The following research project was designed to test the utility of this sign in the diagnosis of lumbar facet joint pain. Methods: We conducted a prospective evaluation of patients suspected of having low back pain secondary to facet joint involvement (Lumbar Facet joint Pain Syndrome – LFPS) during a twelve month observation period; candidate patients were evaluated clinically using the new diagnostic sign, which was then compared to findings on radionuclide bone scans and diagnostic medial branch blocks. Contingency table analysis was performed to calculate the sensitivity, specificity, positive and negative predictive values and accuracy of the new clinical sign. Results: Contingency table analysis showed the following operating characteristics for the new diagnostic sign: Sensitivity: 70.37%, Specificity: 50%, Positive predictive value: 90.47%, Negative predictive value: 20% and accuracy 67.7%. Conclusions: Although the new clinical sign failed to show the same operating characteristics as the ones originally described, it has high sensitivity coupled with a good positive predictive value. We consider that although the sign by itself is not diagnostic of lumbar facet joint pain, its presence should alert the clinician to the diagnosis and the possibility of requiring additional testing. Level of Evidence III; Case control studyg. |
publishDate |
2018 |
dc.date.none.fl_str_mv |
2018-12-01 |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
http://old.scielo.br/scielo.php?script=sci_arttext&pid=S1808-18512018000400303 |
url |
http://old.scielo.br/scielo.php?script=sci_arttext&pid=S1808-18512018000400303 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
10.1590/s1808-185120181704160077 |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
text/html |
dc.publisher.none.fl_str_mv |
Sociedade Brasileira de Coluna |
publisher.none.fl_str_mv |
Sociedade Brasileira de Coluna |
dc.source.none.fl_str_mv |
Coluna/Columna v.17 n.4 2018 reponame:Coluna/Columna instname:Sociedade Brasileira de Coluna (SBCO) instacron:SBCO |
instname_str |
Sociedade Brasileira de Coluna (SBCO) |
instacron_str |
SBCO |
institution |
SBCO |
reponame_str |
Coluna/Columna |
collection |
Coluna/Columna |
repository.name.fl_str_mv |
Coluna/Columna - Sociedade Brasileira de Coluna (SBCO) |
repository.mail.fl_str_mv |
coluna.columna@uol.com.br||revistacoluna@uol.com.br |
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1752126615950721024 |