The femoral stretching test

A valuable sign in diagnosing upper lumbar disc herniations

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✓ The femoral stretching test is a valuable sign in diagnosing upper lumbar nerve root compression. We believe that it has the same significance for upper lumbar disc herniation as the sciatic stretching test has for the lower.

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Address reprint requests to: M. N. Estridge, M.D., 399 East Highland Avenue, Suite 520, San Bernardino, California 92404.

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    The femoral stretching test. With the patient prone, the examiner places a palm at the popliteal fossa as the knee is strongly dorsiflexed. Excruciating pain is produced in the anterior aspect of the thigh and/or back. In this position, hamstring power can be tested. Distinct weakness will usually be found with L-5 or S-1 nerve root lesions.

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    Case 1. Pantopaque myelogram showing the defect over the L-3 vertebral body. The asterisk is used routinely as a ready reference to the side of the patient's pain when the film is viewed in the operating room.

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    Case 2. Pantopaque myelogram showing a defect at the L-3 level.

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    Case 3. Pantopaque myelogram showing an extreme lateral herniation of the L-4 disc compressing the L-4 root. A hypertrophic facet is seen, but produced no symptoms.

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    Drawing of an extreme lateral herniation of the L-4 disc. The cause for the positive femoral stretching test was not found until the facet was removed. Although the patient was freed of thigh pain, a spinal fusion was later required because of continuing backache.

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