Accuracy of magnetic resonance imaging in detecting lumbo-sacral nerve root compromise: a systematic literature review.
MRI is considered to be the diagnostic tool of choice in diagnosing nerve root compromise among patients presenting with clinical suspicion of lumbo-sacral radiculopathy. There exists controversy among researchers and clinicians regarding the diagnostic utility and accuracy of MRI in detecting nerve root compromise and radiculopathy. This review evaluated 4 primary diagnostic accuracy studies that specifically assessed the accuracy of MRI in detecting nerve root compromise, as established in the current literature.



Eight electronic data bases were searched for relevant articles from inception until January 2014. All primary diagnostic studies which investigated the accuracy of MRI in diagnosing nerve root compromise among patients with low back and referred leg symptoms were screened for inclusion. Qualifying studies were retrieved and independently assessed for methodological quality using the 'Quality Assessment of Diagnostic tests Accuracy Studies' criteria.



Four studies qualified for inclusion in this review. The sensitivity of MRI in detecting lumbar nerve root compromise was very low at 0.25 (95 % CI) while the specificity was relatively high at 0.92 (95 % CI).



There is lack of sufficient high quality scientific evidence in support or against the use of MRI in diagnosing nerve root compression and radiculopathy. Therefore, clinicians should always correlate the findings of MRI with the patients' medical history and clinical presentation in clinical decision making.
Department of Rehabilitative Sciences, College of Health Sciences, Jomo Kenyatta University of Agriculture & Technology, P.O. Box 62 000 00200, Nairobi, Kenya. ntawa@jkuat.co.ke.
Nassib
N
Tawa
Department of Physiotherapy, Faculty of Community and Health Sciences, University of the Western Cape, Private Bag X 17, Bellville, 7535, Republic of South Africa.
Anthea
A
Rhoda
Department of Physiotherapy, Faculty of Community and Health Sciences, University of the Western Cape, Private Bag X 17, Bellville, 7535, Republic of South Africa.
Ina
I
Diener
D056324:Diffusion Tensor Imaging; D006801:Humans; D008161:Lumbosacral Region / Q000000981:diagnostic imaging* / Q000294:innervation; D008279:Magnetic Resonance Imaging / Q000379:methods*; D011843:Radiculopathy / Q000000981:diagnostic imaging*; D012680:Sensitivity and Specificity; D013126:Spinal Nerve Roots / Q000000981:diagnostic imaging*
Accuracy; Diagnosis; Lumbo-sacral radiculopathy; MRI