Diagnostic accuracy of diagnostic imaging for lumbar disc herniation in adults with low back pain or sciatica is unknown; a systematic review

Chiropractic & Manual Therapies
Jung-Ha KimArianne P Verhagen

Abstract

We aim to summarize the available evidence on the diagnostic accuracy of imaging (index test) compared to surgery (reference test) for identifying lumbar disc herniation (LDH) in adult patients.For this systematic review we searched MEDLINE, EMBASE and CINAHL (June 2017) for studies that assessed the diagnostic accuracy of imaging for LDH in adult patients with low back pain and surgery as the reference standard. Two review authors independently selected studies, extracted data and assessed risk of bias. We calculated summary estimates of sensitivity and specificity using bivariate analysis, generated linked ROC plots in case of direct comparison of diagnostic imaging tests and assessed the quality of evidence using the GRADE-approach.We found 14 studies, all but one done before 1995, including 940 patients. Nine studies investigated Computed Tomography (CT), eight myelography and six Magnetic Resonance Imaging (MRI). The prior probability of LDH varied from 48.6 to 98.7%. The summary estimates for MRI and myelography were comparable with CT (sensitivity: 81.3% (95%CI 72.3-87.7%) and specificity: 77.1% (95%CI 61.9-87.5%)). The quality of evidence was moderate to very low. The diagnostic accuracy of CT, myelography and MRI of to...Continue Reading

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Citations

Jan 20, 2019·Personality and Social Psychology Review : an Official Journal of the Society for Personality and Social Psychology, Inc·Naomi EllemersThed van Leeuwen
Jan 8, 2019·Neurosurgical Review·Alaa Eldin ElsharkawyPeter Douglas Klassen
Jan 7, 2020·European Spine Journal : Official Publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society·Brett RocosM John Hutchinson
Jan 12, 2021·Journal of Lasers in Medical Sciences·Behnam Hosseini, Farzad Allameh
Sep 1, 2019·The American Journal of Emergency Medicine·Brit LongMichael Gottlieb
Apr 15, 2021·World Journal of Clinical Cases·Zhi-Xiang ChengXiang-Rui Wang

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Methods Mentioned

BETA
X-ray
imaging techniques

Software Mentioned

Quality Assessment of Diagnostic Accuracy Studies ( QUADAS ) - 2

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