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Related Experiment Videos

Physical signs in lumbar disc hernia

N Vucetic1, O Svensson

  • 1Department of Orthopaedics, Karolinska Institute, Huddinge University Hospital, Sweden.

Clinical Orthopaedics and Related Research
|December 1, 1996
PubMed
Summary

Two key physical signs, lumbar range of motion and crossed straight leg raise (SLR) test, effectively predict lumbar disc hernia severity. These findings aid surgical planning and prognosis for patients with herniated discs.

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Area of Science:

  • Neurosurgery
  • Orthopedics
  • Spinal Surgery

Background:

  • Lumbar disc herniation is a common condition requiring surgical intervention.
  • Accurate pre-operative assessment of hernia degree is crucial for surgical planning and predicting outcomes.
  • Existing diagnostic methods may not always correlate with intraoperative findings.

Purpose of the Study:

  • To determine if specific physical examination signs can predict the degree of lumbar disc herniation.
  • To evaluate the diagnostic value of physical signs in differentiating between contained and uncontained disc herniations.
  • To assess the ability of physical signs to predict annulus fibrosus integrity.

Main Methods:

  • Prospective study of 163 patients undergoing surgery for suspected lumbar disc herniation.

Related Experiment Videos

  • Stepwise discriminant analysis applied to physical examination findings.
  • Correlation of physical signs with intraoperative findings regarding hernia degree and annulus status.

    • Main Results:

    • Lumbar range of motion and crossed straight leg raise (SLR) test were the only significant physical signs.
    • These signs correctly classified 74% of uncontained and 68% of contained hernias.
    • Lumbar range of motion and crossed SLR predicted annulus rupture with 71% accuracy and intact annuli with 80% accuracy.

    Conclusions:

    • Lumbar range of motion and crossed SLR are valuable physical signs for predicting lumbar disc hernia severity.
    • These physical findings are critical for surgical decision-making and prognostic assessment.
    • Neurologic signs have limited value for predicting hernia degree but are important for differential diagnosis.