DIAGNOSTIC AND PROGNOSTIC VALUE OF DEGREE OF SLR IN THE TREATMENT OF MONORADICULAR SIACTICA

Abstract

Background: Sciatica caused by lumbar disc herniation is a common cause of lower back and radicular leg pain. The Straight Leg Raise (SLR) test is widely used as a clinical tool for diagnosing lumbosacral radiculopathy, but its diagnostic accuracy remains debated compared with magnetic resonance imaging (MRI). Objective: To determine the diagnostic accuracy of the traditional Straight Leg Raise (SLR) test for monoradicular sciatica using MRI as the reference standard. Study Design: Diagnostic validation study. Setting: Department of Neurosurgery, Lady Reading Hospital, Peshawar, Pakistan. Duration of Study: From 10-June-2024 to 10-December-2024. Methods: A total of 100 patients presenting with lower back pain and radicular symptoms were enrolled. The SLR test was performed with the patient in the supine position and considered positive if it reproduced characteristic radicular pain at ≤80° of hip flexion. Pain intensity was quantified using a Visual Analogue Scale (VAS). All participants underwent lumbosacral MRI for confirmation of nerve root compression. Diagnostic parameters, including sensitivity, specificity, and overall accuracy, were calculated using a 2×2 contingency table with MRI findings as the gold standard. Results: The mean age of participants was 44.76 years, with a female predominance (54%). The S1 nerve root was the most frequently affected (36%). The SLR test demonstrated a sensitivity of 79.31%, specificity of 69.23%, and an overall diagnostic accuracy of 78.0%. Conclusion: The traditional Straight Leg Raise test remains a practical, simple, and reliable clinical tool for the diagnosis of monoradicular sciatica, demonstrating moderate sensitivity and specificity when compared with MRI.