The Comparative Reliability of Preoperative Diagnostic Methods in Lumbar Disc Surgery

Hakelius, Anders; Hindmarsh, James

doi:10.3109/17453677208991261

Cited by 41 publications

(4 citation statements)

References 3 publications

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“…The SLR and SS both exhibit moderate sensitivity and poor specificity as diagnostic tests. 71,[139][140][141][142] The poor specificity is associated with the membranous connections from the root dural sleeve to the posterior longitudinal ligament and posterior disc, [143][144][145][146] which may account for nonradicular, referred low back symptom provocation in the presence of dural tensioning. 147 Similar test procedures have produced nerve root and dural movement in previous investigations.…”

Section: Category III Findingsmentioning

confidence: 99%

Medical Screening for Red Flags in the Diagnosis and Management of Musculoskeletal Spine Pain

2007

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When a patient presents with pain in the different regions of the spine, the clinician executes a region-appropriate basic examination that includes appropriate historical cues and specific physical examination tests that can be used to identify red flags. The clinical tests include a specific examination of the sensory and motor systems. Test outcomes are best interpreted in context with the entire examination profile, where the sensitivity and specificity of these tests can influence their utility in uncovering red flags. These red flags can be categorized based on the nature and severity or the specific elements of the patient's presentation. Many general red flags can be observed in any region of the spine, while specific red flags must be categorized and discussed for each spinal region. This categorization can guide the clinician in the direction of management, whether that management is aimed at redirecting the patient's care to another specialist, reconsidering the presentation and observing for clusters of findings that may suggest red flags, or managing the patient within the clinician's specialty in context with the severity of the patient's presentation.

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Section: Category III Findingsmentioning

confidence: 99%

Medical Screening for Red Flags in the Diagnosis and Management of Musculoskeletal Spine Pain

2007

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“…Available values of sensitivity and specificity from the literature [11,12,18,19,22] were plotted in a ROC diagram. These figures include sciatica, scoliosis, hypaesthesia, motor weakness, and straight leg raising test.…”

Section: Methodsmentioning

confidence: 99%

A critical assessment of clinical diagnosis of disc herniation in patients with monoradicular sciatica

1996

Acta neurochir

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The diagnostic power or clinical parameters in the diagnosis of lumbar disc herniation in patients with monoradicular pain was evaluated in a prospective study with a 100% verification of the diagnosis. Eighty patients with monoradicular pain corresponding to the fifth lumbar or the first sacral nerve root were included. Pre-operatively a number of clinical parameters were recorded and compared to the intra-operative finding of a disc herniation. The parameters were analysed by receiver operating characteristic (ROC) curves. Results from the available literature were analysed by ROC curves for comparison. In 76% of the cases a disc herniation was discovered. The level of the disc herniation was correctly predicted in 93% of these cases by the location of the pain alone or supplemented by neurological signs. Apart from radicularly distributed pain, all parameters in the present study and in the literature had no or low diagnostic accuracy. Thus, in patients with monoradicular sciatica further clinical parameters do not add to the diagnosis of lumbar disc herniation.

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“…Straight-leg raising was found not to be an accurate predictor of level of protrusion. '*~ 34 The crossed straight-leg-raising test produced similar patterns (Table 5). These figures also confirm the observations of S~h a m '~ who stated that this test when positive is strong evidence that the protrusion will be located more medially (Fig.…”

mentioning

confidence: 52%

The Straight-Leg-Raising Test: A Review

Urban¹

1981

J Orthop Sports Phys Ther

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The Comparative Reliability of Preoperative Diagnostic Methods in Lumbar Disc Surgery

Cited by 41 publications

References 3 publications

Medical Screening for Red Flags in the Diagnosis and Management of Musculoskeletal Spine Pain

Medical Screening for Red Flags in the Diagnosis and Management of Musculoskeletal Spine Pain

A critical assessment of clinical diagnosis of disc herniation in patients with monoradicular sciatica

The Straight-Leg-Raising Test: A Review

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