Alexandre Bellier1,2, A Latreche3, L Tissot3, Y Robert3, P Chaffanjon3, O Palombi3,4. 1. Laboratoire d'Anatomie Des Alpes Francaises (LADAF), Faculty of Medicine, UFR de Médecine de Grenoble, Grenoble Alpes University, Domaine de la Merci, 38706, La Tronche Cedex, France. abellier@chu-grenoble.fr. 2. Medical Evaluation Department, Grenoble Alpes University Hospital, Grenoble Cedex 9, France. abellier@chu-grenoble.fr. 3. Laboratoire d'Anatomie Des Alpes Francaises (LADAF), Faculty of Medicine, UFR de Médecine de Grenoble, Grenoble Alpes University, Domaine de la Merci, 38706, La Tronche Cedex, France. 4. Neurosurgery Department, Grenoble Alpes University Hospital, Grenoble Cedex 9, France.
Abstract
PURPOSE: The pain involved in the herniated discs could be generated by some mobility of the nerve roots during straight leg raising (SLR). SLR produces some movement of nerves, but the magnitude of this displacement needs to be thorough, that is why we have investigated lumbo-sacral nerve root displacement in the spinal canal during the passive straight leg raise (SLR). METHODS: Fourteen cadavers underwent laminectomy to mark the nerve roots of L2-S1 with lead balls. X-rays were taken during different movements imposed on the body: bilateral hip extension, left SLR then right and bilateral SLR. By superimposing these images two by two, the displacement of the nerve roots is quantified numerically during the various SLR maneuvers with respect to the reference position corresponding to the bilateral hip extension. RESULTS: The median range of the different nerve root movements ranged from 0.10 to 0.51 cm (p < 0.05 except for the L2 root) when the left SLR is applied, from 0.26 to 0.48 cm (p < 0.05) with the right SLR and from 0.30 to 0.65 cm (p < 0.05) with a bilateral SLR. No statistically significant relationship was found between age and movement value. CONCLUSIONS: The lumbo-sacral nerve roots in the spinal canal region move statistically significantly in response to the clinically applied SLR test, except for L2 root during the left SLR. This movement is symmetric and greater when a bilateral SLR is applied. These anatomical results are correlated with those observed empirically in clinical practice.
PURPOSE: The pain involved in the herniated discs could be generated by some mobility of the nerve roots during straight leg raising (SLR). SLR produces some movement of nerves, but the magnitude of this displacement needs to be thorough, that is why we have investigated lumbo-sacral nerve root displacement in the spinal canal during the passive straight leg raise (SLR). METHODS: Fourteen cadavers underwent laminectomy to mark the nerve roots of L2-S1 with lead balls. X-rays were taken during different movements imposed on the body: bilateral hip extension, left SLR then right and bilateral SLR. By superimposing these images two by two, the displacement of the nerve roots is quantified numerically during the various SLR maneuvers with respect to the reference position corresponding to the bilateral hip extension. RESULTS: The median range of the different nerve root movements ranged from 0.10 to 0.51 cm (p < 0.05 except for the L2 root) when the left SLR is applied, from 0.26 to 0.48 cm (p < 0.05) with the right SLR and from 0.30 to 0.65 cm (p < 0.05) with a bilateral SLR. No statistically significant relationship was found between age and movement value. CONCLUSIONS: The lumbo-sacral nerve roots in the spinal canal region move statistically significantly in response to the clinically applied SLR test, except for L2 root during the left SLR. This movement is symmetric and greater when a bilateral SLR is applied. These anatomical results are correlated with those observed empirically in clinical practice.
Entities:
Keywords:
Anatomy; Herniated disc; Lasegue’s test; Movement nerve roots; Straight leg raising
Authors: Marinko Rade; Janne Pesonen; Mervi Könönen; Jarkko Marttila; Michael Shacklock; Ritva Vanninen; Markku Kankaanpää; Olavi Airaksinen Journal: Spine (Phila Pa 1976) Date: 2017-08-01 Impact factor: 3.468
Authors: Janne Pesonen; Michael Shacklock; Pekka Rantanen; Jussi Mäki; Lauri Karttunen; Markku Kankaanpää; Olavi Airaksinen; Marinko Rade Journal: BMC Musculoskelet Disord Date: 2021-03-24 Impact factor: 2.362