Madhesh Malini, Eapen Charu, Eappakkam Kumaraswamy Parthasarathy, Palaniswamy Vijayakumar
Department of Physiotherapy, Kasturba Medical College Mangalore, Manipal Academy of Higher Education, Manipal, India.
Aspire Orthopedic Manual Therapy Institute, 201 E John Carpenter Fwy, Suite 600, Irving, TX 75062, USA.
Eur Spine J. 2025 Jul 21. doi: 10.1007/s00586-025-09164-6.
To determine the diagnostic performance of the Compression Overload Test (COLT) compared with the Straight Leg Raise Test (SLRT) in detecting lumbar intervertebral disc herniation (IVDH), using MRI as the reference standard. A secondary objective was to evaluate the correlation between each test and MRI results.
Fifty-three 53 participants (mean age: 37.26 ± 12.16) with MRI-confirmed acute lumbar IVDH were included in the study. COLT and SLRT tests were conducted by the principal investigator, blinded to participant history, clinical findings, and MRI, while the co-investigator collected demographic and clinical data. Diagnostic performance was evaluated by sensitivity, specificity, and receiver operating characteristic (ROC) curve measures.
COLT demonstrated a higher diagnostic yield than SLRT, with a sensitivity of 92% and an overall diagnostic accuracy of 90.57%. It demonstrated moderate agreement with MRI findings (κ = 0.399) and a positive correlation (Φ = 0.428), with an area under the curve (AUC) of 0.793. In contrast, SLRT had no agreement (κ = -0.008) and no correlation (Φ = -0.0274) with MRI and a poor AUC (0.473). MRI predominantly identified L4-L5 herniations (47.5%) and disc bulges (54.5%). Vertebral endplate abnormalities, including Schmorl's nodes and Modic changes, were observed in 20 participants.
COLT showed higher diagnostic utility than SLRT and correlated well with MRI results.
以磁共振成像（MRI）作为参考标准，确定与直腿抬高试验（SLRT）相比，压缩过载试验（COLT）在检测腰椎间盘突出症（IVDH）方面的诊断性能。次要目的是评估每项试验与MRI结果之间的相关性。
本研究纳入了53名经MRI确诊为急性腰椎IVDH的参与者（平均年龄：37.26±12.16岁）。COLT和SLRT试验由主要研究者进行，研究者对参与者的病史、临床发现和MRI结果不知情，而共同研究者收集人口统计学和临床数据。通过敏感性、特异性和受试者操作特征（ROC）曲线测量来评估诊断性能。
COLT的诊断率高于SLRT，敏感性为92%，总体诊断准确率为90.57%。它与MRI结果显示出中度一致性（κ=0.399）和正相关性（Φ=0.428），曲线下面积（AUC）为0.793。相比之下，SLRT与MRI没有一致性（κ=-0.008）和相关性（Φ=-0.0274），AUC较差（0.473）。MRI主要识别出L4-L5节段的椎间盘突出（47.5%）和椎间盘膨出（54.5%）。在20名参与者中观察到椎体终板异常，包括许莫氏结节和Modic改变。
COLT显示出比SLRT更高的诊断效用，并且与MRI结果相关性良好。
