Lumbar Spine Tests

Question 1

Hoover Sign

Answer 1

P: Lack of counter-pressure on the healthy side
I: Lack of organic basis for paralysis (malingering/hysteria) With organic hemiplegia, the patient will still exert downward pressure when attempting to raise paralyzed leg

Question 2

Straight Leg Raiser

Answer 2

P: Radiating pain and/or dull posterior thigh pain
I: Sciatic radiculopathy or tight hamstrings, etc. Positive between 35-70 degrees = possible discogenic sciatic radiculopathy, above 70 degree = tight hamstrings

Question 3

Bragard Sign

Answer 3

P: Radiating pain in posterior thigh
I: Sciatic radiculopathy

Question 4

Buckling Sign

Answer 4

P: Pain in the posterior thigh with sudden knee flexion (buckling)
I: Sciatic radiculopathy

Question 5

Bowstring Sign

Answer 5

P: Pain in the lumbar region or radiculopathy
I: Sciatic nerve root compression, helps rule out tight hamstrings

Question 6

Lasegue Test

Answer 6

P: Reproduction of sciatic pain before 60 degrees
I: Sciatica

Question 7

Milgram Test

Answer 7

P: Inability to perform test and/or low back pain
I: Weak abdominal muscles or space occupying lesion

Question 8

Valsalva Maneuver

Answer 8

P: Radating pain from site of lesion (usually recreating the complain in cervical or lumbar area of the spine)
I: Space occupying lesion (eg. disc pathology)

Question 9

Bechterew Test

Answer 9

P: Reproduction of radicular pain or inability to perform correctly due to tripod sign
I: Sciatic radiculopathy

Question 10

Neri Bowing Test

Answer 10

P: Pain accompanied by flexion of the knee on the affected side and body rotation away from the affected side
I: Positive with a variety of low back pathologies. Hamstring tension on the pelvis may trigger the response

Question 11

Anterior Innominate Test
AKA. Marino Pelvic Maneuver
(Advancement Sign)

Answer 11

P: The inability to bend at the waist more than 45 degrees, because of either or
1. Radiating pain along the sciatic nerve, either unilateral or bilateral
I: Sciatic neuralgia or radiculopathy, etc, possibly due to lumbar disc pathology
2. Low back pain (lumbar or pelvic regions)
I: anterior (rotational) displacement of the ilium relative to the sacrum

Question 12

Lewin Standing Test

Answer 12

P: Radiating pain down the leg causing flexion of the patient’s knee or knees
I: Gluteal, lumbosacral or sacroiliac pathologies

Question 13

Heel Walk

Answer 13

P: Inability to perform test
I: L4-L5 disc lesion (L5 nerve root)

Question 14

Toe Walk

Answer 14

P: Inability to perform test
I: L5-S1 disc lesion (S1 nerve root)

Question 15

Ely Heel to Buttock Test

Answer 15

1. Inability to raise the thigh
I: Iliopsoas spasm 
2. Pain in the anterior thigh
I: Inflammation of lumbar nerve roots
3. Pain in the lumbar region
I: Lumbar nerve root adhesions

Question 16

Goldthwait Sign

Answer 16

P: Localized pain, low back or radiating pain down the leg
I: Lumbosacral or sacroiliac pathology. Pain occurring after the lumbar spineless move = possible limbo-sacral problem. Pain occurring before the lumbars move = possible sacroiliac problem