A CRITICAL-ASSESSMENT OF CLINICAL-DIAGNOSIS OF DISC HERNIATION IN PATIENTS WITH MONORADICULAR SCIATICA

The diagnostic power or clinical parameters in the diagnosis of lumbar disc herniation in patients with monoradicular pain was evaluated in a prospective study with a 100% verification of the diagnosis. Eighty patients with monoradicular pain corresponding to the fifth lumbar or the first sacral nerve root were included. Pre-operatively a number of clinical parameters were recorded and compared to the intra-operative finding of a disc herniation. The parameters were analysed by receive r operating characteristic (ROC) curves. Results from the available li terature were analysed by ROC curves for comparison. In 76% of the cas es a disc herniation was discovered. The level of the disc herniation was correctly predicted in 93% of these cases by the location of the p ain alone or supplemented by neurological signs. Apart from radicularl y distributed pain, all parameters in the present study and in the lit erature had no or low diagnostic accuracy. Thus, in patients with mono radicular sciatica further clinical parameters do not add to the diagn osis of lumbar disc herniation.