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Determination of Sensitivity and Specificity of Straight Leg Raise Test Via Transforaminal Nerve Root Block

2026年8月14日 更新者：Marmara University

This study aims to evaluate the diagnostic accuracy of the straight leg raise test in patients with suspected lumbosacral radicular pain. Lumbosacral radicular pain is often caused by lumbar disc herniation and may radiate from the lower back or buttock to the leg. Although the straight leg raise test is commonly used in clinical practice, its diagnostic performance has been reported to vary.

In this study, diagnostic transforaminal epidural steroid injection or selective nerve root block will be used as the reference standard. The sensitivity, specificity, likelihood ratios, and area under the curve of the straight leg raise test will be calculated. The findings may help guide clinicians in determining when the straight leg raise test is sufficient and when further diagnostic confirmation may be needed.

調査の概要

状態

募集

条件

詳細な説明

Low back pain is one of the leading causes of disability worldwide. Lumbosacral radicular pain is commonly caused by lumbar disc herniation and is characterized by pain radiating from the lower back or buttock to the leg in a dermatomal distribution. The straight leg raise test is a simple and widely used physical examination test for evaluating suspected lumbar radiculopathy; however, its diagnostic accuracy varies across studies.

This study aims to evaluate the diagnostic performance of the straight leg raise test in patients with suspected lumbosacral radicular pain. Diagnostic transforaminal epidural steroid injection or selective nerve root block will be used as the reference standard. Only technically selective injections performed without sedation and with a low volume of short-acting local anesthetic will be included in the analysis. The study will assess the sensitivity, specificity, likelihood ratios, and area under the curve of the straight leg raise test. The results may help clarify when the straight leg raise test is reliable on its own and when additional diagnostic confirmation may be needed for clinical decision-making.

研究の種類

観察的

入学 (推定)

88

連絡先と場所

このセクションには、調査を実施する担当者の連絡先の詳細と、この調査が実施されている場所に関する情報が記載されています。

研究連絡先

研究連絡先のバックアップ

研究場所

  • トルコ（Türkiye）
    • PENDİK
      • Istanbul、PENDİK、トルコ（Türkiye）、34890
        • 募集
        • Marmara University Faculty of Medicine, Pendik Training and Research Hospital, Algology Department Recruiting
        • コンタクト：

参加基準

研究者は、適格基準と呼ばれる特定の説明に適合する人を探します。これらの基準のいくつかの例は、人の一般的な健康状態または以前の治療です。

適格基準

就学可能な年齢

  • 大人
  • 高齢者

健康ボランティアの受け入れ

いいえ

サンプリング方法

非確率サンプル

調査対象母集団

Adult patients aged 18 to 65 years with a preliminary diagnosis of lumbar radicular pain based on medical history, physical examination, and lumbar magnetic resonance imaging, who are scheduled to undergo transforaminal epidural injection targeting the L4, L5, or S1 nerve root, will be included in the study.

説明

Inclusion Criteria:

  • Age between 18 and 65 years.
  • Preliminary diagnosis of lumbar radicular pain based on medical history, physical examination, and lumbar magnetic resonance imaging.
  • Patients scheduled to undergo transforaminal epidural injection targeting the L4, L5, or S1 nerve root.

Exclusion Criteria:

  • Inability to access clinical or procedural records in the hospital system.
  • Absence of available radiological records related to the target level, if required.
  • Inability to provide reliable NRS or straight leg raise test assessment due to cognitive impairment or language barrier.
  • Coagulopathy, defined as INR > 1.5 or platelet count < 80,000/mm³, or inability to discontinue anticoagulant or antiplatelet therapy when required.
  • Local or systemic infection, or skin lesion at the planned injection site.
  • Pregnancy or breastfeeding.
  • Known severe hypersensitivity to iodinated contrast material or local anesthetics.
  • Progressive neurological deficit or cauda equina syndrome.
  • Bilateral or nearly bilateral pain with both sides being prominent and equivalent, or need for therapeutic injection at more than one level during the same session.
  • Epidural injection with local anesthetic and/or steroid at the same level within the last 6 weeks.
  • Active polyneuropathy or other diffuse neuropathies.
  • Active radicular pain originating from nerve roots other than L4, L5, or S1.
  • Requirement for mandatory sedation.

研究計画

このセクションでは、研究がどのように設計され、研究が何を測定しているかなど、研究計画の詳細を提供します。

研究はどのように設計されていますか？

デザインの詳細

コホートと介入

グループ/コホート
Patients with Suspected Lumbosacral Radicular Pain
Patients with suspected lumbosacral radicular pain who undergo clinical evaluation including the straight leg raise test and diagnostic transforaminal epidural steroid injection.

この研究は何を測定していますか？

主要な結果の測定

結果測定
メジャーの説明
時間枠
Diagnostic Performance of the Straight Leg Raise Test
時間枠：Before and 1 hour after diagnostic transforaminal epidural steroid injection.
The diagnostic performance of the straight leg raise test will be evaluated in patients with suspected lumbosacral radicular pain using diagnostic transforaminal epidural steroid injection as the reference standard.
Before and 1 hour after diagnostic transforaminal epidural steroid injection.

二次結果の測定

結果測定
メジャーの説明
時間枠
DN-4 Quastionnaire
時間枠：Before diagnostic transforaminal epidural steroid injection
The DN-4 (Douleur Neuropathique en 4 Questions) is a brief and reliable screening questionnaire used to determine whether a patient's pain is of neuropathic origin. It consists of a total of 10 items. Its name, DN-4, derives from the fact that it includes 4 main sections. Seven of the questions relate to patient-reported sensory symptoms, while three are based on clinical examination findings. Each "yes" response scores 1 point, yielding a total score ranging from 0 to 10. A score above 4 indicates a high likelihood of neuropathic pain.
Before diagnostic transforaminal epidural steroid injection
Diagnostic Performance of the Bragard Test
時間枠：Before and 1 hour after diagnostic transforaminal epidural steroid injection
The diagnostic performance of the Bragard test will be evaluated in patients with suspected lumbosacral radicular pain. The Bragard test will be assessed before and 1 hour after diagnostic transforaminal epidural steroid injection, using the response to the diagnostic intervention as the reference standard.
Before and 1 hour after diagnostic transforaminal epidural steroid injection
Nerve Root Compression Grade on Lumbar Magnetic Resonance Imaging
時間枠：Using available lumbar magnetic resonance imaging during the study period, up to November 1, 2026
The degree of nerve root compression will be evaluated on lumbar magnetic resonance imaging in patients with suspected lumbosacral radicular pain. Nerve root compression grade will be assessed in relation to straight leg raise test results, Bragard test results, pain intensity, and response to diagnostic transforaminal epidural steroid injection.
Using available lumbar magnetic resonance imaging during the study period, up to November 1, 2026
Change in Pain Intensity Assessed by Visual Analog Scale
時間枠：Before and 1 hour after diagnostic transforaminal epidural steroid injection.
Pain intensity will be assessed using the Visual Analog Scale, which ranges from 0 to 10, with higher scores indicating greater pain intensity. Pain intensity will be measured before and 1 hour after diagnostic transforaminal epidural steroid injection. The change in Visual Analog Scale score after the diagnostic intervention will be evaluated in patients with suspected lumbosacral radicular pain.
Before and 1 hour after diagnostic transforaminal epidural steroid injection.
Intervertebral Disc Degeneration Assessed by Pfirrmann Grading Scale
時間枠：Using available lumbar magnetic resonance imaging obtained before or after the diagnostic intervention, up to November 1, 2026
Intervertebral disc degeneration will be evaluated using the Pfirrmann grading scale on lumbar magnetic resonance imaging. The Pfirrmann grading scale ranges from grade I to grade V, with higher grades indicating more severe intervertebral disc degeneration. Pfirrmann grades will be evaluated in relation to clinical findings, straight leg raise test results, pain intensity, and response to the diagnostic intervention in patients with suspected lumbosacral radicular pain.
Using available lumbar magnetic resonance imaging obtained before or after the diagnostic intervention, up to November 1, 2026

協力者と研究者

ここでは、この調査に関係する人々や組織を見つけることができます。

スポンサー

Marmara University

捜査官

  • 主任研究者：MİKDAT CAN KARABIYIK、Marmara University Faculty of Medicine ,Marmara University, Department of Physical Medicine and Rehabilitation
  • スタディディレクター：SERDAR KOKAR、Algology Division, Department of Physical Medicine and Rehabilitation, Marmara University Faculty of Medicine
  • スタディディレクター：OSMAN HAKAN GUNDUZ、Algology Division, Department of Physical Medicine and Rehabilitation, Marmara University Faculty of Medicine
  • スタディディレクター：SAVAŞ ŞENCAN、Algology Division, Department of Physical Medicine and Rehabilitation, Marmara University Faculty of Medicine

研究記録日

これらの日付は、ClinicalTrials.gov への研究記録と要約結果の提出の進捗状況を追跡します。研究記録と報告された結果は、国立医学図書館 (NLM) によって審査され、公開 Web サイトに掲載される前に、特定の品質管理基準を満たしていることが確認されます。

主要日程の研究

研究開始 (実際)

2025年12月11日

一次修了 (推定)

2026年9月1日

研究の完了 (推定)

2026年9月15日

試験登録日

最初に提出

2026年7月6日

QC基準を満たした最初の提出物

2026年7月6日

最初の投稿 (実際)

2026年7月10日

学習記録の更新

投稿された最後の更新 (実際)

2026年8月18日

QC基準を満たした最後の更新が送信されました

2026年8月14日

最終確認日

2026年8月1日

詳しくは

本研究に関する用語

キーワード

追加の関連 MeSH 用語

その他の研究ID番号

  • Straight leg raise

個々の参加者データ (IPD) の計画

個々の参加者データ (IPD) を共有する予定はありますか?

いいえ

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米国FDA規制医薬品の研究

いいえ

米国FDA規制機器製品の研究

いいえ

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