Relationship between straight leg-raising test measurements and area of fat infiltration in multifidus muscles in patients with lumbar disc hernation

Abstract Background Lumbar disc prolapse is a localized herniation of disc beyond intervertebral disc space and is the most common cause of sciatica; the aim of this study is to investigate the efficacy of ultrasound (US)-guided caudal epidural steroid injection (CESI) compared with fluoroscopy (FL)-guided CESI in treatment of patients with refractory lumbar disc prolapse (LDP) with radiculopathy. Results At the beginning of the study, there was no significant difference between both groups in all parameters. (a) Group 1 had significantly improved the straight leg raising and modified Schober tests, VAS, and ODI at 1-month and 3-month post-injection evaluation in comparison to baseline recordings (p < 0.001); (b) Group 2 had significantly improved the straight leg raising and modified Schober tests, VAS, and ODI at 1-month and 3-month post-injection evaluation in comparison to baseline recordings (p < 0.001); and (c) US-guided CESI was not statistically different from the FL-guided CESI in the improvement of the straight leg raising (p = 0.87, 0.82) and modified Schober tests (p = 0.87, 0.82) as well as VAS (p = 0.40, 0.43) and ODI (p = 0.7, 0.2) at 1-month and 3-month post-injection evaluation. In a multivariate analysis using CI = 95%, the significant predictors for a successful outcome were duration < 6 months (p = 0.03, OR = 2.25), target level not L2-3/L3-4 (p < 0.001, OR = 4.13), and LDP other than foraminal type (p = 0.002, OR = 3.78). However, age < 40 years was found to be non-significant in predicting a successful outcome (p = 0.38, OR = 0.98). Conclusion US is excellent in guiding CESI with similar treatment outcomes as compared with FL-guided CESI. Trial registration ClinicalTrials.gov Identifier: NCT03933150.

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LUMBAR DISCECTOMY

The Professional Medical Journal ◽

10.29309/tpmj/2011.18.04.2673 ◽

2011 ◽

Vol 18 (04) ◽

pp. 678-683

Author(s):

M.SHAHID SMAIJA ◽

SHEIKH ATIQ-UR-REHMAN ◽

ASFA KHIZAR

Keyword(s):

Lumbar Disc ◽

Pain Scale ◽

Mri Findings ◽

Disc Disease ◽

Clinical Difference ◽

Constant Pain ◽

Endoscopic Discectomy ◽

Tissue Dissection ◽

Straight Leg Raising ◽

Group B

Background: Discectomy is the standard treatment for lumber disc disease. Fenestration operations involved lot of tissue dissection and so the complications. Instead the endoscopic discectomy involved less tissue dissection but limited exposure. Objectives: The objectives of this study were to compare the outcome of endoscopic discectomy and fenestration discectomy interms of relieve from symptoms and complications. Study Design: Analytic study. Place and duration of study: Neurosurgical unit Bahawal Victoria hospital Bahawalpur, from Feb 2010 to Aug 2010. Patients and Methods: Forty cases fulfilling the inclusion criteria were selected. Efficacy of procedure was determined by improvement in Denis pain scale, Macnab’s criteria and straight leg raising (SLR) improvement. Results: Forty patients divided in two equal groups. Patients of group A underwent fenestration and Group B endoscopic discectomy.60%of patients had left sciatica while 40% of patients had right sciatica. According to Denis pain scale 10% patients had moderate pain, 30% had severe pain and 60% had constant pain. Straight leg raising test showed, 50% patients had less than 30O SLR, 30%patients showed SLR of 31̊ to 40̊ and 20%patients had SLR more than 40O. MRI findings were disc bulging, protrusion and rupture. Considering SLR, Denis pain scale and Mcnabs criteria of pain control there was no clinical difference found between the two operative procedures except in two patients in group B when open discectomy had to be performed. Conclusions: MED is a safe and effective mode of treatment for low back pain in patients with lumbar disc herniation.

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The Study of Fat Infiltration Ratio in Lumbar Paraspinal Muscle of Patient with Herniated Intervertebral Lumbar Disc

Journal of the Korea Academia-Industrial cooperation Society ◽

10.5762/kais.2012.13.11.5254 ◽

2012 ◽

Vol 13 (11) ◽

pp. 5254-5260

Author(s):

Bong-Jun Kong ◽

Jung-Ho Lee ◽

Min-Sik Yong ◽

Jin-Sang Kim

Keyword(s):

Lumbar Disc ◽

Paraspinal Muscle ◽

Fat Infiltration

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Comparison of Outcomes Postoperation between Straight Leg Raising Test Negative and Positive Patients Who Underwent Percutaneous Transforaminal Endoscopic Discectomy for Lumbar Disc Herniation

10.21203/rs.2.15446/v1 ◽

2019 ◽

Author(s):

Feilong Wei ◽

Haoran Gao ◽

Yifang Yuan ◽

Shu Qian ◽

Quanyou Guo ◽

...

Keyword(s):

Lumbar Disc Herniation ◽

Disc Herniation ◽

Lumbar Disc ◽

Related Factors ◽

Significant Difference ◽

Endoscopic Discectomy ◽

Straight Leg Raising ◽

Percutaneous Transforaminal Endoscopic Discectomy ◽

Relevant Factors

Abstract Background: Percutaneous Transforaminal Endoscopic Discectomy is used increasingly in patients with Lumbar Disc Herniation. There is little knowledge on the related factors including SLR test influencing the operation. Therefore, we designed this prospective study to explore the relevant factors influencing postoperative effect of PTED surgery.Methods: Consecutive patients with LDH who came to our hospital from August 2015 to September 2016 and received PTED surgery. 4 kinds of scales including VAS (lumbar/leg), ODI and JOA were measured and reassessed at 1 day, 3 months, 6 months, 12months and 36 months after the PTED to assess their surgical outcomes. Results: All the patients had successful surgery. ODI and VAS (lumbar/leg) decreased in all patients and groups. And there was a statistically significant difference in each postoperative follow-up compared with that before surgery in every visit. In addition, the increase of JOA in postoperation was statistically significant compared with that before surgery. And, there is statistically significant difference between the three subpopulations (patients with SLR Positive (0°-30°), SLR Positive (31°-60°) and SLR Negative (61°-) in the changes of the scores of VAS(leg), ODI and JOA. However, there is no statistically significant difference between the three subpopulations (patients with SLR Positive (0°-30°), SLR Positive (31°-60°) and SLR Negative (61°--RRB- in the changes of the score of VAS(lumbar). Conclusions: PTED showed great effect on treating patients with lumbar disc herniation. And the main scale score such as VAS(leg). ODI and JOA showed that there is a statistically significant difference between the three subpopulations treated by PTED. Patients with SLR negative may get greater benefit from PTED.

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The Clinical Significance of Straight-Leg Raising (Lasègueʼs Sign) in the Diagnosis of Prolapsed Lumbar Disc

Spine ◽

10.1097/00007632-198804000-00003 ◽

1988 ◽

Vol 13 (4) ◽

pp. 393-395 ◽

Cited By ~ 65

Author(s):

MICHAEL KOSTELJANETZ ◽

FLEMMING BANG ◽

SØREN SCHMIDT-OLSEN

Keyword(s):

Clinical Significance ◽

Lumbar Disc ◽

Straight Leg Raising

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The Sensitivity and Specificity of the Slump and the Straight Leg Raising Tests in Patients With Lumbar Disc Herniation

JCR Journal of Clinical Rheumatology ◽

10.1097/rhu.0b013e31816b2f99 ◽

2008 ◽

Vol 14 (2) ◽

pp. 87-91 ◽

Cited By ~ 95

Author(s):

Javid Majlesi ◽

Halit Togay ◽

Halil Ünalan ◽

Sadk Toprak

Keyword(s):

Sensitivity And Specificity ◽

Lumbar Disc Herniation ◽

Disc Herniation ◽

Lumbar Disc ◽

Straight Leg Raising

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Non-surgical treatment with XSHHD for ruptured lumbar disc herniation: a 3-year prospective observational study

BMC Musculoskeletal Disorders ◽

10.1186/s12891-020-03723-2 ◽

2020 ◽

Vol 21 (1) ◽

Author(s):

Feng Dai ◽

Yu Xiang Dai ◽

Hong Jiang ◽

Peng Fei Yu ◽

Jin Tao Liu

Keyword(s):

Surgical Treatment ◽

Nucleus Pulposus ◽

Lumbar Disc Herniation ◽

Disc Herniation ◽

Lumbar Disc ◽

Secondary Outcome ◽

Outcome Measurements ◽

Straight Leg Raising ◽

Magnetic Resonance Imaging Mri ◽

Non Surgical Treatment

Abstract Background Lumbar disc herniation (LDH) is mainly caused by annular fiber disruption with a discrete leakage of nucleus pulposus pressing on a nerve, resulting in back pain and radiating pain. Most patients with LDH can be treated conservatively, but there are many different conservative treatments. Furthermore, most previous studies did not evaluate the long-term efficacy of these treatments and the prognosis. Therefore, an effective and safe therapeutic strategy is lacking for patients with LDH. In this study, we evaluated Xiao Sui Hua He decoction (XSHHD) in the treatment of LDH. Methods This was a rigorous prospective observational 3-year follow-up study. We recruited 69 participants with ruptured lumbar disc herniation (RLDH) between February 2014 and February 2016. Patients took XSHHD orally twice a day for 6 months. The primary outcome measurements were visual analogue scale (VAS) pain score, Oswestry disability index (ODI) and straight leg raising test (SLRT). The secondary outcome measurements was nucleus pulposus protrusion volume on magnetic resonance imaging (MRI). Clinical outcomes were measured at baseline (Visit 1), and at 3, 6, 12, and 36 months (Visit 2, 3, 4, and 5, respectively).. Results Sixty-three patients were followed-up for 3 years after treatment. SLRT and ODI after non-surgical treatment improved significantly compared with baseline (P < .001). There were no statistically significant differences at 6 months vs 36 months for SLRT and ODI. VAS scores (leg, back) after 3 years of treatment were statistically significantly different compared with baseline (P < .001; Z = − 6.93, − 6.637). The baseline protrusion volume was 2018.61 ± 601.16 mm3, and the volume decreased significantly to 996.51 ± 387.42 mm3 at 36 months (t = 12.863; P < .001). The volume of protrusion resorption rate (VPRR) at 36 months was 47.24 ± 23.99%, with significant resorption in 23 cases, partial resorption in 23 cases, no resorption in 15 cases, and increased volume in 2 cases. Conclusions This study showed that non-surgical treatment with XSHHD was effective, and the study clarified the natural outcomes in LDH.

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