Journal List > J Korean Soc Spine Surg > v.10(1) > 1035585

Ahn, Lee, Kwon, and Hong: Intraoperative Straight Leg Raising Test During Arthroscopic Microdiscectomy

Abstract

Study Design

A prospective study.

Purpose

To assess the effectiveness of the straight leg raising test during an arthroscopic microdiscectomy.

Materials and Methods

52 patients, 38 men and 14 women, took part in this experiment. The mean followed up and age were 21, ranging from 13 to 41 months, and 26.4, ranging from 13 to 42 years old. There were 19, 28 and 9 cases between the 3rd-4th lumbar vertebrae, between the 4- 5th lumbar vertebrae between the 5th lumbar vertebra and the 1st sacral vertebra, respectively. 41 patients were able to perform the SLRT (straight leg raising test) procedure, and were called group I, and 11 patients could not perform the test, and were classed as group II. In order to perform the intraoperative SLRT, a lateral decubi-tus position was adopted. A fter the disc removal, the SLRT was carried out. When the test result gave an angle of 70 degrees or greater, the surgery was carried out on a pertinent domain. The success of the surgery was graded by the JOA score.

Results

In group I, after removal of the disc, the first 31 patients were checked over a 4 week period to assess their recoveries. A year after the surgery, their follow up results were better than Good. In 9 patients, there were little improvements from the first SLRT, so they were re- tested after a 2nd discectomy, which resulted in improvements., with better than good results. 1 patient, whose test result was fair after four weeks and one year, was diagnosed with spinal stenosis, so underwent an operation. In group II, the SLRT during surgery was untestable, due to overweight and uncooperative patients. The results in 3 patients were fair, and in another 8 they better than good. Overall, 97.6% of the patients in group I showed a rapid recovery, but in the group II, only 72.2% showed a rapid recovery.

Conclusion

From the short term follow up, the use of a SLRT during surgery is very effective. Further research is required to give more precise results.

REFERENCES

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Fig. 1.
Positioning of patient during arthroscopic lumbar discectomy.
jkss-10-25f1.tif
Fig. 2.
This picture shows the technique of intraoperative straight leg raising test.
jkss-10-25f2.tif
Table 1.
Judgement of effect of surgery (score rating system of the Japanese Orthopaedic Association)
  Excellent Good Fair Poor
Radicular pain - intermittent + intermittent + +
Tension sign - - intermittent + +
Expressed Satisfaction Yes Yes Not bad No
Returned to work Yes Yes (intermittent limited) No No
Table 2.
Follow up results of Straight leg raising test (Group I).
Case No. SLRT POD 4 weeks POD 1 year
    Excellent : 25 Excellent : 20
31 cases intraop. 1st SLRT : Sx. was relieved   Good : 5
Good : 6 Excellent : 1
      Good : 5
    Excellent : 4 Excellent : 3
9 cases intraop. 1st SLRT : Sx. was not relieved   Good : 1
  intraop. 2nd SLRT : Sx. was relieved Good : 5 Good : 5
      Complicated :
1 case intraop. 2nd SLRT : Sx. relief was not significant Fair spinal stenosis & reop. was done

SLRT: Straight leg raising test

Table 3.
Follow up results of straight leg raising test (Group II).
Case No. SLRT POD 4 weeks POD 1 year
    Excellent : 2  
  Intraop. SLRT cannot be performed : Excellent : 7 Good : 3
11 cases due to obesity (9 cases), Fair : 2  
  incoorporation (2 cases) Good : 4 Good : 3
    Fair : 1  
SLRT
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