Abstract
Objective
The aim of this retrospective study was to assess validity of the straight-leg raise
(SLR) test using magnetic resonance imaging (MRI) results as a reference standard
in a group of patients with L4-L5 and L5-S1 lumbar-herniated disks and sciatic pain.
The relationship between diagnostic accuracy of this test, age classes, and grade
of lumbar disk displacement was investigated.
Methods
The charts of 2352 patients with sciatic pain with/without lumbar pain were examined.
Results of the SLR were then compared with previous spinal MRI. A 2 × 2 contingency
table was created, and analysis of sensitivity, specificity, positive and negative
predictive values, diagnostic odds ratio, likelihood ratio (LR), and receiver operating
characteristic (ROC) curve was carried out. Homogeneous age classes were created to
compare them statistically.
Results
Magnetic resonance imaging findings showed lumbar disk herniation (LDH) in 1305 patients.
Of these subjects, 741 were positive on SLR testing. Sensitivity was 0.36, whereas
specificity was 0.74. Positive and negative predictive values were 0.69 and 0.52,
respectively. Positive LR was 1.38, and negative LR was 0.87. Diagnostic odds ratio
was 1.59, and ROC analysis showed an area under the curve (AUC) of 0.596. The AUC
decreased from 0.730 in the 16- to 25-year subgroup to 0.515 in the 76- to 85-year
subgroup. Similar results were obtained in subjects with LDH and nerve root compression.
Conclusions
Our results indicate low accuracy of the SLR in diagnosis of LDH if compared with
MRI results. The discriminative power of the SLR seemed to decrease as age increased;
thus, positive and negative results may be less conclusive in older patients.
Key Indexing Terms
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Article info
Publication history
Published online: May 06, 2011
Accepted:
April 3,
2011
Received in revised form:
March 31,
2011
Received:
February 4,
2011
Identification
Copyright
© 2011 National University of Health Sciences. Published by Elsevier Inc. All rights reserved.
