Study of the Diagnostic Accuracy of the Neurodynamic Tests in Patients With Lumbar Radiculopathy

Lumbar radiculopathy is a relevant cause of disability and morbidity, accounting for between 23 and 57% of the cases of patients with low back pain and representing a significant expense due to the sick leave and health care that may be required.Nuclear magnetic resonance and electromyography are the most commonly used tests for the diagnosis of the pathology.Neurodynamic tests represent a sequence of structured movements with the purpose of increasing the mechanical stress of the neural tissue. These tests are currently an important aspect of the physical examination of the patient when there is suspicion of neural involvement, allowing the physiological and mechanical capacities of the nerve to be evaluated.The Slump and Straight Leg Raise neurodynamic tests are the two best known tests for assessing the mechanosensitivity of the sciatic nerve and its component roots.The hypothesis of this observational study is that the straight leg raising and Slump neurodynamic tests with precise diagnostic criteria are valid tools for the diagnosis of lumbar radiculopathy.

Inclusion Criteria:Being between 18 and 75 years of age.Having symptoms compatible with lumbar radiculopathy at the time of the study. Intermittent or constant pain in the lumbar area or radiating to a distal extremity, to the gluteal fold; or distribution of pain in all or part of the dermatomic area of one or two adjacent lumbosacral nerve roots (L3-S2 segments).Have undergone or are awaiting MRI of the lumbar region.Have been referred for an electrophysiological study of the sciatic nerve or its branches.Have sufficient comprehension and communication skills to be able to communicate their symptoms and their characteristics.Accept and give their consent to participate voluntarily in the study and provide their clinical data anonymously.Exclusion Criteria:Having radiological tests with a diagnosis of spondylolysis and/or spondylolisthesis in the lumbar region.Having been diagnosed with diabetes, thyroid dysfunction, rheumatoid arthritis, heart and/or lung disease, alcoholism, HIV+, herpes zoster infection, multiple sclerosis, hereditary neuropathy or any known neurodegenerative disease and/or pregnancy.Have undergone lumbar surgery and/or transforaminal epidural steroid injection within the previous 12 months.Have received physiotherapeutic neurodynamic treatment.Have suffered a fracture of any vertebrae of the spine.Have been diagnosed with other compressive causes or causes that produce irritation of the lumbar roots or stenosis of the spinal canal.Be unable or have contraindications to adopt the supine decubitus and/or seated position with lumbar, dorsal and cervical flexion or to maintain the position for the duration of the tests.Present any physical contraindication (red flags) such as neoplastic processes, serious infections; or psychological contraindication (yellow flags) such as psychiatric pathologies that could influence the state of the subjects or the results of the study.That the MRI is performed more than 12 months after the clinical examination.Failure to complete all the assessment phases of the study.