The Sensitivity of the Seated Straight-Leg Raise Test Compared With the Supine Straight-Leg Raise Test in Patients Presenting With Magnetic Resonance Imaging Evidence of Lumbar Nerve Root Compression

Abstract 

Rabin A, Gerszten PC, Karausky P, Bunker CH, Potter DM, Welch WC. The sensitivity of the seated straight-leg raise test compared with the supine straight-leg raise test in patients presenting with magnetic resonance imaging evidence of lumbar nerve root compression.

Objective

To compare the sensitivity of 2 methods of performing the straight-leg raise (SLR) test, one in the supine position and the other in the seated position, in patients presenting with signs and symptoms consistent with lumbar radiculopathy.

Design

A cohort study in which patients with signs and symptoms consistent with lumbar radiculopathy and magnetic resonance imaging (MRI) results available for review at the time of participation were assessed with both the supine and the seated SLR test.

Setting

A large neurosurgical referral office.

Participants

Seventy-one consecutive patients with signs and symptoms consistent with lumbar radiculopathy referred for evaluation of low back pain were prospectively recruited.

Interventions

Not applicable.

Main Outcome Measures

Supine SLR and seated SLR. MRI was used as the criterion standard.

Results

The sensitivity of the supine SLR test was .67 compared with a sensitivity of .41 of the seated SLR test (P=.003).

Conclusions

The traditional SLR test performed in a supine position is more sensitive in reproducing leg pain than the seated SLR test in patients presenting with signs of and symptoms consistent with lumbar radiculopathy and MRI evidence of nerve root compression.

Key Words: Neurologic examination, Lumbar region, Radiculopathy, Rehabilitation