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Sciatic tension signs and lumbar disc herniation

L F Supik1, M J Broom

  • 1Orlando Regional Healthcare System, Florida.

Spine
|May 1, 1994
PubMed
Summary

Sciatic stretch tests correlate well with lumbar disc herniation surgery findings. The straight leg lift is the most sensitive sign for diagnosing nerve root compression due to disc pathology.

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Area of Science:

  • Neurosurgery
  • Orthopedic Surgery
  • Diagnostic Medicine

Background:

  • Sciatic tension maneuvers, including straight leg lift and Lasègue's sign, have been used since the 1880s to differentiate sciatica from hip pain.
  • These tests aim to identify nerve root compression.

Purpose of the Study:

  • To correlate specific sciatic stretch diagnostic maneuvers with the anatomic location and level of lumbar disc pathology.
  • To evaluate the effectiveness of these maneuvers in predicting intraoperative findings.

Main Methods:

  • Prospective evaluation of 50 consecutive patients with clinical and radiographic evidence of lumbar disc herniation.
  • Physical examination included straight leg lift, cross leg lift, Lasègue's sign, and bowstring sign.
  • Intraoperative assessment of herniated disc location and type (protrusion/extrusion).

Main Results:

  • The straight leg lift demonstrated the highest sensitivity in correlating preoperative physical examination findings with intraoperative pathology.
  • Sciatic stretch maneuvers showed a high correlation with surgical pathology in patients with lumbar disc herniation.

Conclusions:

  • Physical diagnostic maneuvers for sciatic tension are reliable indicators in patients with confirmed lumbar disc herniation.
  • These signs can guide further diagnostic evaluations.
  • No specific correlation was found between the maneuvers and the precise location of the herniated disc relative to the nerve root.

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