A Study of the Relationship between Straight Leg Raising, Valsalva Test and Size, Position of Lumbar Disc Herniation

요추부 추간판 탈출 정도와 SLR, valsalva test의 관계

  • Published : 2013.04.30

Abstract

Objectives : This study investigated the relationship between straight leg raising(SLR), valsalva test and size, position of lumbar disc herniation. Methods : We took SLR and valsalva test on 105 patients with lumbar disc herniation. According to the result of MRI findings, this study classified three groups of 105 patients with lumbar disc herniation, bulging, protrusion and extrusion. According to the position of lumbar disc herniation, 72 patients that were diagnosed protrusion and extrsuion were sorted 4 groups, lateral, lateral postero-lateral, central postero-lateral, central. The association size, position of lumbar disc herniation and SLR, valsalva test were analysed. Results : The bigger size of disc herniation, the more positive result of SLR and valsalva test, the lower angle of SLR test. There was not significant association between the position of lumbar disc herniation and the angle of SLR test. Conclusions : The SLR and valsalva test is an useful physical examination to speculate about the degree of lumbar disc herniation.

Keywords

Straight leg raising test;Valsalva test;Lumbar disc herniation

References

  1. Halbertsma JPK, Ludwig NH, Johan WG, Willem HE. Extensibility and stiffness of hamstrings in patients with nonspecific low back pain. Arch Phys Med Rehabil. 2001;82:232-8. https://doi.org/10.1053/apmr.2001.19786
  2. McClure PW, Esola M, Schreier R, Siegler S. kinematic analysis of lumbar and hip motion while rising from forwaed, flexed position in patients with and without a history of low back pain. Spine. 1997;22(5):552-8. https://doi.org/10.1097/00007632-199703010-00019
  3. Van der Windt DA, Simons E, Riphagen II, Ammendolia C, Verhagen AP, Laslett M, Devillé W, Deyo RA, Bouter LM, de Vet HC, Aertgeerts B. Physical examination for lumbar radiculopathy due to disc herniation in patients with low-back pain. Cochrane Database Systemic Reviews. 2010:17;(2):CD007431.
  4. 강정훈. 요천추 추간판 탈출환자에서 하지 직거상 검사의 임상적 가치. 조선대학교 대학원 의학과 석사논문. 2008.
  5. Thelander U, Fagerlund M, Friberg S, Larsson S. Straight leg raising test versus radiologic size, shape, and position of lumbar disc hernias. Spine. 1992;17(4):395-9. https://doi.org/10.1097/00007632-199204000-00003
  6. Summers B, Malhan K, Cassar-Pullicino V. Low back pain on passive straight leg raising : the anterior as a source of pain. Spine. 2005;30(3):342-5. https://doi.org/10.1097/01.brs.0000152378.93868.c8
  7. Bruce reider. 척추와 사지의 검진. 서울:군자출판사. 2006:393-4.
  8. 이일훈, 정제화, 김철. 요통환자의 하지직거상 검사와 근전도 및 방사선학적 소견의 비교. 대한재활의학회지. 1996;20(2):333-8.
  9. 최호영. 임상근육학. 서울:대성의학사. 1999:500-13.
  10. 이양균. 요통의 이학적 진단. 대한임상통증학회지. 2003;2(2):92-7.
  11. Forst JJ. Contributiona l'etude clinique de la sciaique. Paris:These. 1881:33.
  12. Vroomen PC, de Korm MC, Wilmink JT, Kester AD, Knottnerus JA. Diagnostic value of history and physical examination in patients suspected of lumbosacral nerve root compression. Journal of neurology neurosurgery and psychiatry. 2002;72:630-4. https://doi.org/10.1136/jnnp.72.5.630
  13. Denille, Walter LJM. The test of laseque : Systematic review of the accuracy in diagnosing herniated discs. Spine. 2000;25(9):1140-7. https://doi.org/10.1097/00007632-200005010-00016
  14. Love JG, Walsh MN. Protruded intervertebral disc(fibrovartilage). Proceedings of the royal society of medicine. 1939;32:1697-721.
  15. Knutsson B. Comparative value of electromyographic, myelographic and clinical neurological examination in diagnosis of lumbar root compression syndrome. Acta Orthp. 1961:49.
  16. Spangfort EV. The lumbar disc herniation. Acta Orthp. 1972:142.
  17. Vroomen PC, de Korm MC, Knottnerus JA. Diagnostic value of history and physical examination in patients suspected of sciatica due to disc herniation: a systematic review. Journal of Neurology. 1999;246(10):899-906. https://doi.org/10.1007/s004150050480
  18. Michael devereuaux. Low back pain. Medical clinics of north america. 2009;93(2):477-501. https://doi.org/10.1016/j.mcna.2008.09.013
  19. 이환모, 박문수. 요추부 추간판 탈출증의 분류 및 영상진단. 대한척추외과학회지. 2001;8(3):314-20.
  20. 박지선, 류경남. 요추질환의 자기공명영상소견. 대한임상통증학회지. 2003;2(2):98-111.
  21. 신병철, 신준식, 이종수, 임형호. 정형추나의학. 척추신경추나의학회. 2006;211-3.
  22. Stephen I. Esses. text book of spinal disorder. 서울:군자출판사. 2002:68-9.
  23. 대한정형외과학회. 정형외과학 제6판. 서울:최신의학사. 2006:625.
  24. Majlesi J. Togay H, Unalan H, Toprak S. The Sensitivity and Specificity of the Slump and the Straight Leg Raising Tests in Patients With Lumbar Disc Herniation. Journal of Clinical Rheumatology. 2008;14(2):87-91. https://doi.org/10.1097/RHU.0b013e31816b2f99
  25. 송미영, 이강수, 이명종. 요추간판탈출증 진단에 있어 교통사고 환자와 비교통사고 환자의 하지직거상 검사상 진단적 가치 비교 연구. 한방재활의학과학회지. 2005;15(2):67-75.