Neurological examination for cervical radiculopathy: a scoping review

Key Points

1. Neural mechanosensitivity testing and provocative maneuvers do not identify sensory or motor functional loss.

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BACKGROUND AND OBJECTIVE

Cervical radiculopathy (CR) is a common clinical referral and is not clearly diagnosed (1). The lack of consistency with diagnosis is the focus of this scoping review. The authors discuss the inconsistent definition of CR among clinical guidelines and the associated differences of clinical or research assessment of CR for diagnostic consistency. This would ultimately help researchers and clinicians to establish the clinical utility of the BNE.

The International Association for the Study of Pain (IASP) defines radiculopathy as a loss of sensory and/or motor function due to action potential conduction slowing or blockage of a spinal nerve or its roots (2). This does not include pain or paresthesia which are indicative of increased excitability at the dorsal root or dorsal root ganglia and are not considered diagnostic criteria for CR (2).

The clinical tests for CR that follow the IASP definition include the bedside neurological examination (BNE) of peripheral sensory and motor responses (light touch, pinprick, temperature, myotomal weakness, and reduced tendon reflexes). The authors aimed to establish the components, performance, and diagnostic accuracy of the BNE for CR.

The International Association for the Study of Pain defines radiculopathy as a loss of sensory and/or motor function due to action potential conduction slowing or blockage of a spinal nerve or its roots.

The standard bedside neurological examination should include examination of muscle function, tendon reflexes, light touch, warm/cold sensation, and pin-prick testing.

METHODS

• This is a scoping review of the literature, and the protocol was registered prior.

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