Sensibility testing in patients with a lumbosacral radicular syndrome.
OBJECTIVE
To examine whether there is a significant difference in gnostic sensibility between affected and unaffected legs of patients suffering from lumbosacral radicular syndrome (LRS) resulting from a disc herniation and to determine the validity of the sensibility test for detecting a disc herniation.


METHODS
Observer blind study of sensibility testing.


METHODS
Four general hospitals (neurology department) and one practice of physical and manual therapy.


METHODS
Fifty-one patients with radicular pain in the lumbosacral nerve roots for at least 4 wk and/or neurological deficits.


METHODS
The gnostic sensibility of 51 patients with a unilateral LRS was tested using Semmes-Weinstein monofilaments for the L4, L5 and S1 dermatomes.


RESULTS
Gnostic hypoesthetic impairments in the L4, L5 and S1 dermatomes were found in 84.6% of the 43 patients in which the presence of disc herniation was confirmed by CT. There was significant difference in gnostic sensibility between the affected and unaffected legs in the L4, L5, and S1 dermatomes for disc herniation at the L4-L5 level and for the L5 and S1 dermatomes for a disc herniation at the L5-S1 level. There was no significant difference in gnostic sensibility in the L4 dermatome for a disc herniation at the L5-S1 level.


CONCLUSIONS
The gnostic sensibility of the affected leg is hypoesthetic compared with the unaffected leg. The specificity of the sensibility test using monofilaments is acceptable, but the sensitivity is not. The monofilament test is a useful and practical tool for excluding the presence of a disc herniation at dermatomes L4, L5 and S1 and disc herniations at the L4-L5, L5-S1 level.
Peeters
G G
GG
BackCenter and Care- and Prevention Center Uden, The Netherlands.
Aufdemkampe
G
G
Oostendorp
R A
RA
D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D007405:Intervertebral Disc Displacement / Q000150:complications / Q000175:diagnosis*; D017116:Low Back Pain / Q000209:etiology; D008161:Lumbosacral Region / Q000294:innervation*; D008297:Male; D008875:Middle Aged; D009129:Muscle Tonus; D009460:Neurologic Examination; D015203:Reproducibility of Results; D013577:Syndrome; D020196:Trauma, Nervous System