下肢神经根病和坐骨神经痛的体格检查
Physical assessment of lower extremity radiculopathy and sciatica.
作者信息
Miller Kenneth Jeffrey
机构信息
Chairperson, Department of Clinical Sciences, Cleveland Chiropractic College, Kansas City, MO 64131.
出版信息
J Chiropr Med. 2007 Jun;6(2):75-82. doi: 10.1016/j.jcme.2007.04.001.
Abstract
OBJECTIVE
The purpose is to describe active and passive physical maneuvers that provoke or alleviate lumbosacral radiculopathy and/or sciatica to demonstrate how these maneuvers function in common orthopedic and neurological tests/signs.
METHODS
Descriptions of the maneuvers and their countermaneuvers are provided to establish an understanding of their mechanisms and influence on lumbosacral nerve roots and the sciatic nerve. Common tests and signs for lower extremity radiculopathy and sciatica are described to demonstrate the clinical application of the maneuvers. Combinations of common tests are also offered to improve examination efficiency.
RESULTS
Understanding how each maneuver contributes individually or in combination with standard tests will enhance the reader's examination skills.
CONCLUSION
Improved examination skills lead to improved diagnosis and differential diagnosis of lower extremity radiculopathy and sciatica.
摘要
目的
描述引发或缓解腰骶神经根病和/或坐骨神经痛的主动和被动物理手法，以展示这些手法在常见骨科和神经学检查/体征中的作用方式。
方法
提供手法及其对抗手法的描述，以帮助理解其机制以及对腰骶神经根和坐骨神经的影响。描述了下肢神经根病和坐骨神经痛的常见检查和体征，以展示这些手法的临床应用。还提供了常见检查的组合方式，以提高检查效率。
结果
了解每种手法单独或与标准检查结合的作用，将提高读者的检查技能。
结论
提高检查技能有助于改善下肢神经根病和坐骨神经痛的诊断及鉴别诊断。
相似文献
1
Physical assessment of lower extremity radiculopathy and sciatica.下肢神经根病和坐骨神经痛的体格检查
J Chiropr Med. 2007 Jun;6(2):75-82. doi: 10.1016/j.jcme.2007.04.001.
2
The relationship between history and physical examination findings and the outcome of electrodiagnostic testing in patients with sciatica referred to physical therapy.坐骨神经痛患者接受物理治疗时，其病史和体格检查结果与电诊断检查结果的关系。
J Orthop Sports Phys Ther. 2014 Jul;44(7):508-17. doi: 10.2519/jospt.2014.5002. Epub 2014 May 22.
3
Specificity of diagnostic nerve blocks: a prospective, randomized study of sciatica due to lumbosacral spine disease.诊断性神经阻滞的特异性：一项关于腰骶部脊柱疾病所致坐骨神经痛的前瞻性随机研究。
Pain. 1996 Apr;65(1):77-85. doi: 10.1016/0304-3959(95)00170-0.
4
Physical examination for lumbar radiculopathy due to disc herniation in patients with low-back pain.对下背痛患者因椎间盘突出导致的腰椎神经根病进行体格检查。
Cochrane Database Syst Rev. 2010 Feb 17(2):CD007431. doi: 10.1002/14651858.CD007431.pub2.
5
6
Diagnostic value of history and physical examination in patients suspected of lumbosacral nerve root compression.病史及体格检查对疑似腰骶神经根受压患者的诊断价值
J Neurol Neurosurg Psychiatry. 2002 May;72(5):630-4. doi: 10.1136/jnnp.72.5.630.
7
Sciatic tension signs and lumbar disc herniation.坐骨神经张力体征与腰椎间盘突出症
Spine (Phila Pa 1976). 1994 May 1;19(9):1066-9. doi: 10.1097/00007632-199405000-00013.
8
Magnetic resonance neurography in extraspinal sciatica.脊髓外坐骨神经痛的磁共振神经成像
Arch Neurol. 2006 Oct;63(10):1469-72. doi: 10.1001/archneur.63.10.1469.
9
["Lumbar intervertebral disk-induced sciatica" diagnostic error in extensive extra- and intrapelvic lipoma].[广泛盆腔内外脂肪瘤中“腰椎间盘源性坐骨神经痛”的诊断错误]
Z Orthop Ihre Grenzgeb. 1999 Jul-Aug;137(4):362-5. doi: 10.1055/s-2008-1039726.
10
[Differential sciatica pain diagnosis from the neurologic viewpoint].
Med Klin (Munich). 1997 Jun 15;92(6):335-43. doi: 10.1007/BF03044774.
引用本文的文献
1
The Relationship between Magnetic Resonance Imaging and Functional Tests Assessment in Patients with Lumbar Disk Hernia.腰椎间盘突出症患者磁共振成像与功能测试评估之间的关系
Healthcare (Basel). 2023 Oct 1;11(19):2669. doi: 10.3390/healthcare11192669.
2
Comparison of magnetic resonance imaging findings among sciatica patients classified as centralizers or non-centralizers.坐骨神经痛患者中以中枢型或非中枢型分类的磁共振成像结果比较。
J Man Manip Ther. 2023 Oct;31(5):358-367. doi: 10.1080/10669817.2023.2174555. Epub 2023 Feb 8.
3
Risk Factors, Prevention, and Primary and Secondary Management of Sciatica: An Updated Overview.坐骨神经痛的危险因素、预防以及一级和二级管理：最新综述
Cureus. 2022 Nov 12;14(11):e31405. doi: 10.7759/cureus.31405. eCollection 2022 Nov.
4
Use of Neurodynamic or Orthopedic Tension Tests for the Diagnosis of Lumbar and Lumbosacral Radiculopathies: Study of the Diagnostic Validity.神经动力或矫形张力测试在腰椎和腰骶神经根病诊断中的应用：诊断有效性研究。
Int J Environ Res Public Health. 2020 Sep 26;17(19):7046. doi: 10.3390/ijerph17197046.
5
[The piriformis syndrome-a special indication for botulinum toxin].[梨状肌综合征——肉毒杆菌毒素的一种特殊适应症]
Nervenarzt. 2020 Feb;91(2):99-106. doi: 10.1007/s00115-020-00866-4.
6
Sensitivity and Specificity of Modified Bragard Test in Patients With Lumbosacral Radiculopathy Using Electrodiagnosis as a Reference Standard.以电诊断为参考标准，评估改良布拉加德试验在腰骶神经根病患者中的敏感性和特异性。
J Chiropr Med. 2018 Mar;17(1):36-43. doi: 10.1016/j.jcm.2017.10.004. Epub 2018 Jan 12.
7
How to proceed when evidence-based practice is required but very little evidence available?当需要循证实践但可用证据极少时该如何进行？
Chiropr Man Therap. 2013 Jul 10;21(1):24. doi: 10.1186/2045-709X-21-24.
本文引用的文献
1
The slump test: examination and treatment.坍落度试验：检查与治疗。
Aust J Physiother. 1985;31(6):215-9. doi: 10.1016/S0004-9514(14)60634-6.
2
Piriformis syndrome resulting from a rare anatomic variation.由罕见解剖变异导致的梨状肌综合征。
Spine (Phila Pa 1976). 2006 Aug 15;31(18):E664-6. doi: 10.1097/01.brs.0000231877.34800.71.
3
Intrathecal movement and tension of the lumbosacral roots induced by straight-leg raising.直腿抬高引起的腰骶神经根鞘内移动及张力
Am J Phys Med Rehabil. 2006 Mar;85(3):222-7. doi: 10.1097/01.phm.0000200386.28819.6a.
4
Slump stretching in the management of non-radicular low back pain: a pilot clinical trial.非根性下腰痛管理中的垂位伸展：一项初步临床试验
Man Ther. 2006 Nov;11(4):279-86. doi: 10.1016/j.math.2005.07.002. Epub 2005 Dec 27.
5
The mannequin sign.人体模型征
Spine (Phila Pa 1976). 2005 Mar 1;30(5):E115-7. doi: 10.1097/01.brs.0000155692.98146.5f.
6
Low back pain on passive straight leg raising: the anterior theca as a source of pain.被动直腿抬高试验时的下腰痛：前鞘膜作为疼痛来源
Spine (Phila Pa 1976). 2005 Feb 1;30(3):342-5. doi: 10.1097/01.brs.0000152378.93868.c8.
7
IN VIVO MEASUREMENTS OF INTRADISCAL PRESSURE. DISCOMETRY, A METHOD FOR THE DETERMINATION OF PRESSURE IN THE LOWER LUMBAR DISCS.椎间盘内压力的体内测量。椎间盘测压法，一种测定下腰椎间盘压力的方法。
J Bone Joint Surg Am. 1964 Jul;46:1077-92.
8
BIOMECHANICS OF THE LUMBOSACRAL NERVE ROOTS.
Acta Radiol Diagn (Stockh). 1963 Nov;1:1141-60. doi: 10.1177/028418516300100603.
9
A systematic review of the passive straight leg raising test as a diagnostic aid for low back pain (1989 to 2000).一项关于被动直腿抬高试验作为腰痛诊断辅助手段的系统评价（1989年至2000年）。
Spine (Phila Pa 1976). 2002 Sep 1;27(17):E388-95. doi: 10.1097/00007632-200209010-00025.
10
Characteristics of patients with lower extremity symptoms treated with slump stretching: a case series.采用垂头弯腰伸展法治疗的下肢症状患者的特征：病例系列
J Orthop Sports Phys Ther. 2002 Aug;32(8):391-8. doi: 10.2519/jospt.2002.32.8.391.
Zotero 插件