Sensibilidade das manobras de Laségue e de slump nos diagnósticos de hérnia e abaulamento discal em comparação com ressonância magnética

• Published in: Revista brasileira de ortopedia 2021-12, Vol.56 (6), p.761-765
• Main Authors: Miranda, Isabel Hahn, Raymundo, José Luiz Pozo, Klein, Kevin Maahs
• Format: Article
• Language: Portuguese
• Subjects: Artigo Original
• ISSN: 0102-3616; 1982-4378
• DOI: 10.1055/s-0040-1722590

Resumo Objetivo  Mostrar a acurácia das manobras mais usadas no diagnóstico clínico da lombociatalgia, a manobra de slump e a de Laségue. Métodos  Para a realização do presente estudo, foram selecionados 101 pacientes com discopatia na ressonância magnética (RM) (padrão ouro), sendo posteriormente realizada a revisão dos prontuários para identificar quais tiveram as manobras positivas no exame físico inicial. Resultados  A sensibilidade encontrada para as manobras de slump e Laségue no diagnóstico de hérnia discal foi respectivamente 55,3% e 18,1%. Já quando comparamos as manobras para o diagnóstico de abaulamento discal, a sensibilidade obtida foi de 85,7% para a manobra de slump e de 28,6% para a manobra de Laségue. Conclusão  Foi constatado que a manobra de slump apresenta sensibilidade superior à da manobra de Laségue tanto para o diagnóstico de hérnia quanto para o de abaulamento discal quando comparadas a RM, e deveria estar mais presente na prática clínica. Abstract Objective  To show the accuracy of the most used maneuvers in the clinical diagnosis of lumbosciatalgia, the slump test and the Laségue sign. Methods  In order to perform the present study, 101 patients with magnetic resonance imaging (MRI) discopathy (gold standard) were selected and had their medical records reviewed to identify which had the positive maneuvers on the initial physical examination. Results  The sensitivity found for the slump test and the Laségue sign in the diagnosis of disc herniation was 55.3% and 18.1%, respectively. Nonetheless, when they were compared with each other for the diagnosis of disc bulging, the sensitivity obtained was of 85.7% for the slump test and of 28.6% for the Laségue sign. Conclusion  Comparing both clinical exams with MRI, it was found that the slump test presents superior sensitivity compared with the Laségue sign for both the diagnosis of hernia and disc bulging, and should be more present in clinical practice.