Use of Neurodynamic or Orthopedic Tension Tests for the Diagnosis of Lumbar and Lumbosacral Radiculopathies: Study of the Diagnostic Validity

Monteros, Francisco Javier González Espinosa de Los; González-Medina, Gloria; Garrido-Ardila, Elisa María; Mansilla, Juan Rodríguez; Expósito, José; Ruiz, Petronila Oliva

doi:10.3390/ijerph17197046

Cited by 19 publications

(13 citation statements)

References 45 publications

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“…These results oppose the other situation where people with less physical activity tend to have DH. According to our results and the evidence from the literature, we can conclude that the gold standard for DH diagnosis is SLUMP and not the LASEGUE test [19,48].…”

Section: Discussionsupporting

confidence: 53%

The Relationship between Magnetic Resonance Imaging and Functional Tests Assessment in Patients with Lumbar Disk Hernia

Antohe,

Uysal,

Panaet

et al. 2023

Healthcare

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Although magnetic resonance imaging (MRI) findings are the gold standard for diagnosing herniated discs, there are many limitations to accessing MRI scanning devices in practice. This study aimed to evaluate the relationship between functional tests (the visual analog scale (VAS), the SLUMP test, the Sciatica Bothersomeness Index (SBI), the Oswestry Disability Index (ODI), and the LASEGUE test and MRI findings (LSA, IVDH L4-L5, IVDH L5-S1, DHS L4-L5, and DHS L5-S1) in patients diagnosed with disc herniation. Seventy-eight patients who met the inclusion criteria participated in the study. Radiologists and neurologists evaluated patients with disc herniation. After the disc hernia diagnosis, the patients were referred to a physical therapist for conservative management of the disk hernia. The physical therapists assessed the pain level and performed functional tests on patients. All statistical analyses were performed using R (Core Team) software. The correlation between the measured variables was conducted using the Pearson and Spearman tests. The study results indicated statistically significant correlations between DHS L4-L5 vertebral level and functional tests (VAS: r = 0.49, p = 0.00; SBI: r = 0.44, p = 0.00; ODI: r = 0.49, p = 0.00; LASEGUE: r = −0.48, p = 0.00; SLUMP: r = 0.50, p = 0.00). In conclusion, physiotherapists may prefer functional tests to diagnose the herniated disc, and these functional tests may contribute to performing evidence-based assessments.

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Section: Discussionsupporting

confidence: 53%

The Relationship between Magnetic Resonance Imaging and Functional Tests Assessment in Patients with Lumbar Disk Hernia

Antohe,

Uysal,

Panaet

et al. 2023

Healthcare

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“…However, some patients who have large intervertebral disc herniation, according to imaging, have very mild symptoms of pain in the lower back leg. Therefore, González Espinosa de Los Monteros et al [9] proposed to check the patient's nerve root status by measuring their neurodynamic or orthopedic tension. The results of the slump test and Dejerine's triad test combined with straight leg test and Bragard test in multiple parallel manners showed the highest diagnostic accuracy and validity.…”

Section: Discussionmentioning

confidence: 99%

Intraoperative Measurements of Nerve Root Tension During Posterior Lumbar Interbody Fusion

Zhu

2021

Preprint

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Background There is no effective standard method to evaluate whether the nerve root tension is restored, which is an important indicator for the recovery of nerve function. This study aimed to demonstrate a technique for measuring nerve root tension during surgery. Methods A total of 54 consecutive patients (average age, 52.3 years; range, 28-68 years) received posterior lumbar interbody fusion for lumbar disc herniation comprised the patient sample.The nerve root tension was measured twice before and after intraoperative decompression by the nerve root tension meter modified from the transverse gauge by author. Clinical outcome was assessed by the visual analog scale (VAS) for leg pain, provided by patients before and after surgery. Results There was a significant improvement in the VAS score for leg pain after surgery compared with that before surgery (7.0 ± 2.24 vs. 0.8 ± 0.84, respectively; P < 0.01). Nerve root tension was significantly decreased after decompression compared with that before surgery (1.32 ± 0.22 N vs. 0.64 ± 0.17 N, respectively; P < 0.01). The nerve root tension was positively correlated with the VAS score (r = 0.772, P < 0.05; r = 0.715, P < 0.05). Conclusions This study shows that the nerve root tension meter can instantly and non-invasively measure nerve root tension during an operation. It was demonstrated that the nerve root tension of the patient is significantly reduced after decompression. Meanwhile, the VAS score improved significantly, and the nerve root tension and VAS scores were positively correlated.

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“…[7][8][9] However, some patients who have large intervertebral disc herniation according to imaging may have very mild symptoms of pain in the lower back leg. Therefore, Gonz alez Espinosa de Los Monteros et al 10 proposed to check the patient's nerve root status by measuring their neurodynamic or orthopaedic tension. The results of the slump test and Dejerine's triad test combined with the straight leg test and Bragard test in multiple parallel manners showed the highest diagnostic accuracy and validity.…”

Section: The Relationship Between Nerve Root Tension and Nerve Injurymentioning

confidence: 99%

Effects of Different Intervertebral Space Heights on Nerve Root Tension during Posterior Lumbar Interbody Fusion

Zhu

2023

Orthopaedic Surgery

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Objective There is no effective standard method to evaluate whether the nerve root tension is restored during lumbar decompression surgery, which is an important indicator for the recovery of nerve function. This study aimed to investigate the feasibility of intraoperative nerve root tension measurement and to confirm the correlation between nerve root tension and intervertebral space height. Methods A total of 54 consecutive patients (mean age, 54.3 years; range, 25–68 years) received posterior lumbar interbody fusion (PLIF) for lumbar disc herniation (LDH) with lumbar spinal stenosis and instability. The 110%, 120%, 130%, 140% height values of each lesion were calculated based on preoperative measurements of the intervertebral space height. The heights were intraoperatively expanded after the intervertebral disc was removed using the interbody fusion cage model. The tension value of nerve root was measured by pulling the nerve root for 5 mm with a self‐made measuring device. The nerve root tension value was measured before decompression, after discectomy at 100%, 110%, 120%, 130%, and 140% of the height of each intervertebral space, and after placement of the cage during intraoperative nerve root tension monitoring. Results The nerve root tension values at 100%, 110%, 120%, and 130% heights were significantly lower than those before decompression, and there was no statistical significance among the four groups. The nerve root tension value was significantly higher at 140% height and was statistically significant compared with that of 130% height. The nerve root tension value after cage placement was significantly lower than that before decompression (1.32 ± 0.22 N vs. 0.61 ± 0.17 N, p < 0.01), and the postoperative VAS score was also significantly improved (7.0 ± 2.24 vs. 0.8 ± 0.84, p < 0.01). The nerve root tension was positively correlated with the VAS score (F = 85.19, p < 0.01; F = 78.65, p < 0.01). Conclusion This study demonstrates that nerve root tonometry can perform instant noninvasive intraoperative nerve root tension measurement. There is a correlation between nerve root tension value and VAS score. We found that when the height of the intervertebral space was increased to 140% of the original height, the nerve root tension increased the risk of injury significantly.

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Use of Neurodynamic or Orthopedic Tension Tests for the Diagnosis of Lumbar and Lumbosacral Radiculopathies: Study of the Diagnostic Validity

Cited by 19 publications

References 45 publications

The Relationship between Magnetic Resonance Imaging and Functional Tests Assessment in Patients with Lumbar Disk Hernia

The Relationship between Magnetic Resonance Imaging and Functional Tests Assessment in Patients with Lumbar Disk Hernia

Intraoperative Measurements of Nerve Root Tension During Posterior Lumbar Interbody Fusion

Effects of Different Intervertebral Space Heights on Nerve Root Tension during Posterior Lumbar Interbody Fusion

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