Inadequacies of the Lasègue test, and how the Slump and Bowstring tests are useful for the diagnosis of sciatica

Berthelot, Jean‐Marie; Darrieutort-Laffite, Christelle; Arnolfo, Paul; Glémarec, Joëlle; Goff, Benoît Le; Maugars, Yves

doi:10.1016/j.jbspin.2020.06.004

Cited by 9 publications

(7 citation statements)

References 49 publications

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“… 12 There is insufficient evidence on use of other tests for clinical diagnosis of LHD (Bragard test, Christodoulides test – femoral stretch test, slump test, Bowstring test, cough impulse test, Bell test, hyperextension test, lumbar range of motion, absence of reflexes). 63 , 64 …”

Section: Resultsmentioning

confidence: 99%

Lumbar disc herniation: Epidemiology, clinical and radiologic diagnosis WFNS spine committee recommendations

Pojskic,

Bisson,

Oertel

et al. 2024

World Neurosurgery: X

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Section: Resultsmentioning

confidence: 99%

Lumbar disc herniation: Epidemiology, clinical and radiologic diagnosis WFNS spine committee recommendations

Pojskic,

Bisson,

Oertel

et al. 2024

World Neurosurgery: X

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“…The Lasegue test is one of the essential findings showing the presence of a herniated disc when examining cases with a prediagnosis of low‐level lumbar disc herniation. (Asan, 2018; Berthelot et al, 2021; Miller, 2007; Spangfort, 1972; Vroomen et al, 1999) This test, also known as the Straight Leg Raise Test (SLRT), involves traction of the sciatic nerve. (Deville et al, 2000; Majlesi et al, 2008; Poiraudeau et al, 2001; Rebain et al, 2002) As a rule of geometry, it can be explained that the longest side of a right triangle is always the hypotenuse.…”

Section: Discussionmentioning

confidence: 99%

The Lasegue test: Defining its specificity and sensitivity based on geometry

Asan

2022

Clinical Anatomy

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The Lasegue test -also known as the straight leg raise test-, used for diagnostic purposes in cases of lumbar disc herniation can be explained by geometrical rules.This study aimed to describe the relationship between the apical and basal size of the herniated disc and the Lasegue test, and to describe the specificity and sensitivity of the herniated disc as a function of its height, location, and size. The study evaluated cases diagnosed with lumbar disc herniation with available MRI scans and Lasegue test results. The radix length to the foramen was calculated by recording the apical length and the base length of the herniated disc. The level and apical direction of the herniated discs were also recorded to determine the specificity and sensitivity of the test. Data from a total of 865 cases were analyzed. The apical length of the herniated disc was the most critical criterion for determining the Lasegue test. The Lasegue test is most sensitive and specific in lateral herniated discs at the level of L4-5. The specificity and sensitivity are decreased in L3-4, migrated, and sequestered disc herniations. In these cases, false-negative results may occur. Sensitivity decreases in the median and paramedian herniated discs.Compression of the sciatic nerve reduces herniated disc straightness. The Lasegue test is a test that can be defined according to the rules of geometry. Knowing the factors that decrease specificity and sensitivity and cause false positive/negative results will facilitate correct diagnosis.

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“…FETD allows for enlargement of the neural foramen, and foraminal discectomy can achieve sufficient decompression, but when the nerve damage is severe, it may be difficult for the patient to recover completely. A positive SLR indicates extra tension on the nerve, increasing root ischaemia 21 . These may be the reasons for our result.…”

Section: Discussionmentioning

confidence: 99%

Comparison of postoperative outcomes between patients with positive and negative straight leg raising tests who underwent full-endoscopic transforaminal lumbar discectomy

Wei

Gao

Yan

et al. 2020

Sci Rep

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Full-endoscopic transforaminal lumbar discectomy (FETD) is increasingly used in patients with lumbar disc herniation (LDH). There is little knowledge on the related factors, including the straight leg raising test (SLR), that influence the operation. Consecutive patients with LDH who came to our hospital from August 2015 to September 2016 and underwent FETD surgery were included. Four kinds of scores, including the VAS (lumbar/leg), ODI and JOA values, were measured and reassessed after FETD to assess the surgical outcomes. There was a statistically significant difference between the scores before surgery and at each postoperative follow-up. In addition, the increase in the JOA score postoperatively was statistically significant compared with that before surgery. There were statistically significant differences among the three subpopulations [patients considered SLR positive (0°–30°), SLR positive (31°–60°) and SLR negative (61°–)] in the changes in the VAS (leg), ODI and JOA values. However, there were no statistically significant differences among the three subpopulations [patients considered SLR positive (0°–30°), SLR positive (31°–60°) and SLR negative (61°–)] in the changes in VAS score (lumbar). FETD showed great effectiveness in treating patients with lumbar disc herniation. Patients who were SLR negative may receive greater benefit from FETD.

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Inadequacies of the Lasègue test, and how the Slump and Bowstring tests are useful for the diagnosis of sciatica

Cited by 9 publications

References 49 publications

Lumbar disc herniation: Epidemiology, clinical and radiologic diagnosis WFNS spine committee recommendations

Lumbar disc herniation: Epidemiology, clinical and radiologic diagnosis WFNS spine committee recommendations

The Lasegue test: Defining its specificity and sensitivity based on geometry

Comparison of postoperative outcomes between patients with positive and negative straight leg raising tests who underwent full-endoscopic transforaminal lumbar discectomy

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