Türk Nöroşirürji Dergisi 2000 , Vol 10 , Num 1
Aşkın GÖRGÜLÜ1, Sabahattin ÇOBANOĞLU1, Hakan ÖZSÜER1, Osman ŞİMŞEK1, Galip EKUKLU2
1Trakya Üniversitesi Tıp Fakültesi Nöroşirürji
2Trakya Üniversitesi Tıp Fakültesi Halk Sağlığı Anabilim Dalı, Edirne
In this prospective study, fifty consecutive cases with clinical and radiographic evidence of lumbar disc herniation were examined. Correlation between sciatric nerve stretch maneuvers and intraoperative evaluation of surgical pathology regarding level and anatomic location and pain related symptoms in lumbar disc herniation were evaluated preoperatively and 4 months postoperatively. Initial physical examination included evaluation of sciatric tension signs using the straight leg raising, cross leg raising, Lasegue sign, Bowstring and Bragard tests. Pain at rest, at night and with moving was recorded. Consumption of analgesics were classified into three categories; none, intermittent, regular. Walking capacity was recorded as more than 5 km, between 0.5-5 km, and less than 0.5 km. At the time of surgery 50 patients were assessed for anatomic location of disc herniation and presence of disc protrusion and extrusion. The straight leg raising test was the most sensitive preoperative physical diagnostic sign for correlating intraoperative pathology of lumbar disc herniation. Also positiveness of all tests preoperatively correlated with good outcome of the surgical procedure. There was almost linear correlation between positiveness of all sciatic nerve maneuvers and pain at night and reduction of walking capasity (less than 5 km) but no such correlation was found between positiveness of all sciatic nerve maneuvers and consumption of analgesics. Anahtar Kelimeler : Lumbar disc herniation, sciatric nerve stretch maneuvers, sraight leg raising test