Straight Leg Raise Test

Excerpt

The straight leg raise test also called the Lasegue test, is a fundamental neurological maneuver during the physical examination of a patient with lower back pain that seeks to assess the sciatic compromise due to lumbosacral nerve root irritation. This test, which was first described by Dr. Lazarevic and wrongly attributed to Dr. Lasegue, can be positive in various conditions, making lumbar disc herniation the most common. Nonetheless, there are multiple causes of a positive test, such as facet joint cysts or hypertrophy. Overall, this test is one of the most commonly performed maneuvers across clinical practice and provides important information when making the clinical decision to refer a patient to a specialist, as well as among spinal surgeons, to guide therapeutic decision-making.

Low back pain is one of the most common complaints among active workers and a significant cause of absenteeism from work. Sciatic pain is radiating pain from the buttocks to the legs and is frequently associated with low back pain. In this regard, the neurological examination is fundamental in discriminating patients with isolated lower back pain from those with associated radiculopathy. Consequently, early recognition of radiculopathy allows targeted treatment and diminishes disability. The specificity of the straight leg raise test has been reported to be low, limiting the diagnosis accuracy. However, the clinical usefulness of this test remains important both for general practitioners and spine surgeons. It should still be considered a relevant component of the physical examination that, associated with proper imaging studies, can lead to an accurate diagnosis and treatment.

Therefore the objective is to describe the maneuver technique, pathophysiology, history, and usefulness of this common test through a review of the literature.