(Golden Oldie) Accuracy of clinical tests in detecting disk herniation and nerve root compression in subjects with lumbar radicular symptoms

Review written by Dr Sarah Haag info

Key Points

  1. Positive clinical assessments do not accurately identify the presence of a herniated disk or nerve root compression on MRI.
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BACKGROUND & OBJECTIVE

The prevalence of low back pain, with or without sciatica, is a major medical problem worldwide. Lumbar radicular symptoms are assessed clinically with neurodynamic tests and neurological examination tests. While these tests are used to assess radicular symptoms, it is not known if clinical tests can accurately identify presence of a disk herniation or nerve compression.

This study aimed to investigate the accuracy of the slump test, straight-leg raise test and femoral nerve neurodynamic test, as well as neurological signs in detecting disk herniation and nerve root compression.

The prevalence of low back pain, with or without sciatica, is a major medical problem worldwide.
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This study found no strong correlation between positive clinical tests and disk herniation or nerve root compression.

METHODS

This prospective cohort study included 100 patients who were referred for transforaminal epidural steroid injection in Sweden. MRI’s were performed and the images were assessed by a radiologist. The clinical assessment was performed by one experienced physiotherapist.

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