2006 Young Investigator Award winner:: Lumbosacral nerve root displacement and strain part 2.: A comparison of 2 straight leg raise conditions in unembalmed cadavers

Study Design. An inferential cadaveric study. Objectives. To compare the displacement and strain of the lumbosacral nerve roots during different conditions of straight leg raise (SLR) with intact foraminal ligaments. Summary of Background Data. Clinicians use sensitizing movements such as dorsiflexion during neurodynamic testing, assuming that these prepositions influence the displacement or strain to the lumbosacral nerve roots. Little is known about the effect of these prepositions on neurodynamic behavior. Methods. Lower limbs and associated nerve roots of 5 unembalmed cadavers (n = 10) were used to evaluate the displacement and strain of the L4, L5, and S1 roots during 2 different SLR conditions. Fluoroscopic images of intraneural metal markers were digitized to evaluate displacement and strain during SLR with no preposition ( SLR NPP) of the ankle and SLR with dorsiflexion preposition ( SLR DF) of the ankle, respectively. Results. SLR NPP produced larger distal displacement at L5 and S1, ( P < 0.001) when compared with SLR DF. Displacement comparisons at L4 were nonsignificant ( P = 0.051). While nonsignificant, medium to large effect sizes (0.60-0.96) suggest that SLR DF may produce more strain than the SLR NPP condition. Conclusions. Prepositions of the SLR test alter the displacement and possibly the strain of the lumbosacral nerve roots in the lateral recess.