The DOI matches its Crossref record; 10 of the 10 references it cites were found in a registry or an index.
Diagnostic performance of the medial hamstring reflex in L5 radiculopathy
Open accessAbstract
BACKGROUND: An avalanche of literature exists on almost every aspect of lumbar disc pathology but very limited studies have quantified the diagnostic performance of elements of clinical examination in predicting disc level, meticulously collated the reflex changes in lumbar disc herniation (LDH) as well as assessed the diagnostic performance of the medial hamstring reflex (MHR). Our study underscores the diagnostic performance of the MHR in L5 radiculopathy comparing its diagnostic power to that of the knee and ankle reflexes. METHODS: One hundred consecutive patients operated for de novo LDH in our department between January and December 2011 were prospectively followed-up. A nested case control study was designed from our cohort to assess the performance of the MHR in L5 sciatica. All patients were examined by two independent examiners pre-operatively for the MHR and the results collated and correlated to MRI and intra-operative findings. RESULTS: The MHR has a diagnostic performance intermediate to that of knee and ankle reflexes. The percentages correctly classified were respectively: 86%, 79% and 67% for the knee, MHR and ankle reflexes. The MHR is highly precise with an intra-rater reliability of 100% and inter-rater repeatability of above 90% and test-retest reproducibility of 100%. CONCLUSION: The MHR hitherto described as elusive has a high diagnostic performance and is a valid neurologic test that should be included in the routine neurologic examination of patients with suspected L5 radiculopathy.
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“It is mediated primarily by the tibial portion of the sciatic nerve (L5) and is the only DTR useful in evaluating suspected L5 radiculopathy.”
From Deep Tendon Reflex: The Tools and Techniques. What Surgical Neurology Residents Should Know (2021) · cites this paper as [18]
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Vroomen, P. C. A. J., de Krom, M. C. T. F. M., & Knottnerus, J. A. (1999) · Journal of Neurology · doi:10.1007/s004150050480 · Cited by 172
van Rijn, J. C., Klemetsö, N., Reitsma, J. B., Majoie, C. B. L. M., Hulsmans, F. J., Peul, W. C., Bossuyt, P. M., den Heeten, G. J., & Stam, J. (2005) · Clinical Neurology and Neurosurgery · doi:10.1016/j.clineuro.2005.10.003 · Cited by 54
Poiraudeau, S. (2001) · British journal of rheumatology · doi:10.1093/rheumatology/40.4.460 · Cited by 45
The level-diagnosis of a lower lumbar disc herniation: The value of sensibility and motor testing
Jensen, O. H. (1987) · Clinical Rheumatology · doi:10.1007/bf02330594 · Cited by 42
Hancock, M. J., Koes, B. W., Ostelo, R., & Peul, W. C. (2011) · Spine · doi:10.1097/brs.0b013e3181ee7f78 · Cited by 30
The medial hamstring reflex in the level-diagnosis of a lumbar disc herniation
Jensen, O. H. (1987) · Clinical Rheumatology · doi:10.1007/bf02330595 · Cited by 21
Reihani‐Kermani, H. (2004) · Annals of Saudi Medicine · doi:10.5144/0256-4947.2004.273 · Cited by 12
Asymmetric hamstring reflexes indicative of L5 radicular lesions.
Felsenthal, G., & Reischer, M. A. (1982) · PubMed · Cited by 11
[Does asymmetric hamstring reflex indicate L5 radicular lesion?].
Calmels, P., & Minaire, P. (1986) · PubMed · Cited by 1
Cited by
Deep Tendon Reflex: The Tools and Techniques. What Surgical Neurology Residents Should Know
Lin-Wei, O., Sang Xian, L. L., Wei Shen, V. T., Yong Chuan, C., Abdul Halim, S., Ghani, A. R. I., Idris, Z., & Abdullah, J. M. (2021) · Malaysian Journal of Medical Sciences · doi:10.21315/mjms2021.28.2.5 · Cited by 13
Metadata
- Authors
- Ngene, E., Elzoghby, M., Kotb, A., Meher, A., El-Bahy, K., & El-Hakim, A.
- Affiliations
- Ain Shams University (EG)
- Venue
- Surgical Neurology International
- Publisher
- Scientific Scholar
- Published
- 2012
- Volume
- 3
- Issue
- 1
- Pages
- 104
- ISSN
- 2152-7806 (ISSN-L)
- PMC
- PMC3475886
- OpenAlex
- W2011773501
- Cited by
- 10
- References
- 10
- Citations by year
- 2026: 1 · 2025: 1 · 2024: 1 · 2023: 1 · 2021: 2 · 2020: 1 · 2018: 1 · 2017: 1 · 2016: 1
- FWCI
- 0.00
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Licence
- cc-by-nc-sa
- Locations
- Surgical Neurology International (publishedVersion)
- PubMed Central (publishedVersion, cc-by-nc-sa)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Orthopedics and Sports Medicine › Spine and Intervertebral Disc Pathology
- Health Sciences › Medicine › Clinical Neurology › Peripheral Nerve Disorders
- Health Sciences › Health Professions › Physical Therapy, Sports Therapy and Rehabilitation › Musculoskeletal pain and rehabilitation
- Keywords
- L5 radiculopathy, lumbar disc herniation, knee reflex, ankle reflex, neurological examination, diagnostic accuracy, intra-rater reliability, inter-rater reliability, test-retest reproducibility, MRI correlation
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- Ngene, E., Elzoghby, M., Kotb, A., Meher, A., El-Bahy, K., & El-Hakim, A. (2012). Diagnostic performance of the medial hamstring reflex in L5 radiculopathy. Surgical Neurology International. https://doi.org/10.4103/2152-7806.100862
