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

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 diagnosisof LSS were included in this study. Fifty healthy volunteers were examined as a control group. Theseverity of tenderness was scored (tenderness score) and measured on a visual analogue scale (P-VASscore). These scores were compared between the LSS and control groups. Moreover, they were comparedbefore and after the operation among operated patients.Results: The positive tenderness rate was signiŞcantly higher (92.6% [100/108]) in the LSS group than inthe control group (30% [15/50]). The sensitivity and speciŞcity of TNCT (95% conŞdence interval) were0.93 (0.88e0.96) and 0.70 (0.61e0.77), respectively. Positive tenderness rates and P-VAS scores weresigniŞcantly higher in the LSS group (p < 0.0001). Scores on all measures signiŞcantly improved postoperatively in operated patients (p< 0.0001).Conclusion: The Tibial Nerve Compression Test is a useful screening tool for LSS diagnosis in a primarycare setting.Level of evidence: Level II, diagnostic study© 2017 Turkish Association of Orthopaedics and Traumatology. Publishing services by Elsevier B.V. This isan open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).