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

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.