The Crossed Straight Leg Raising Test: A Diagnostic Sign of Herniated Disc

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Increased sciatica on raising the opposite or “well” leg, the crossed straight leg raising (XSLR) sign, is associated with a herniated lumbar disc in 97% of patients. Although XSLR predicts poor response to conservative management, the results of laminectomy are unusually good, with 91% of patients returning to work. Myelography is unnecessary for the diagnosis of disc herniation in patients with XSLR. It is possible for patients with this sign to have a normal myelogram, but 90% of them will prove nevertheless to have a herniated disc.

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