A case is reported of L3-L4 far lateral disc herniation, in which the femoral stretching and crossed femoral stretching tests were positive.
To discuss the clinical usefulness and pathophysiologic mechanics of the femoral and crossed femoral nerve stretching tests.
The femoral and crossed femoral stretching tests have received little clinical and research attention. The validity of these two nerve root tension signs to evaluate upper disc herniations remains unknown.
A 73-year-old woman presented with progressive low back pain and left anterolateral thigh pain of 2 months' duration. The diagnosis of far lateral disc herniation at L3-L4 was initially suspected from a positive crossed femoral nerve stretch. An open discectomy was performed without complications.
Eight months after surgery, the patient had recovered and the femoral and crossed femoral stretching tests were negative.
It is hypothesized that the crossed femoral stretching test may be a valid maneuver to help in the diagnosis of symptomatic disc herniation above L4.
From the Department of Orthopaedics, Royal University Hospital, Saskatoon, Saskatchewan, Canada.
Supported in part by the Chiropractors' Association of Saskatchewan.
Acknowledgement date: February 23, 1995.
First revision date: June 8, 1995.
Second revision date: September 19, 1995.
Acceptance date: November 13, 1994.
Device status category: 1.
Address reprint requests to: Ken Yong-Hing, MB, ChB, FRCS(Glasgow), FRCSC; Department of Orthopaedic Surgery; Royal University Hospital; 103 Hospital Dr.; Saskatoon, Saskatchewan; Canada S7N 0X0