Femoral Stretch Test in L2-L4 Lumbar Radiculopathy

Root-Level Diagnostic Sensitivity of the Femoral Stretch Test in Patients With L2, L3, or L4 Nerve Root Compression: A Prospective Observational Study

This prospective observational study aims to evaluate the sensitivity of the femoral stretch test in patients with unilateral, single-root L2, L3, or L4 nerve root compression and to determine whether test positivity differs according to the affected nerve root.

Patients with unilateral radicular symptoms and magnetic resonance imaging-confirmed single-root compression involving the L2, L3, or L4 nerve root who are scheduled to undergo transforaminal epidural steroid injection as part of routine clinical care will be included. The decision to perform transforaminal epidural steroid injection will be made independently of participation in the study.

Before the procedure, the femoral stretch test, pain intensity, neuropathic pain characteristics, dermatomal concordance of symptoms, and relevant magnetic resonance imaging findings will be recorded. The femoral stretch test and pain intensity will be reassessed 1 hour after the procedure. The study will primarily evaluate the sensitivity of the femoral stretch test for L2, L3, and L4 nerve root involvement and will also assess changes in test findings following transforaminal epidural steroid injection.

Inclusion Criteria:

• Patients with a diagnosis of lumbar radicular pain based on medical history, physical examination, and imaging findings.
• Patients with unilateral L2, L3, or L4 nerve root involvement who are scheduled to undergo single-level, unilateral transforaminal epidural steroid injection targeting the corresponding nerve root.

Exclusion Criteria:

• Presence of diabetes mellitus or other medical conditions that may cause polyneuropathy.
• Presence of active radicular pain originating from lumbosacral nerve roots other than L2, L3, or L4.
• Unavailability of relevant radiological imaging.
• Cognitive impairment that may interfere with clinical assessment.
• Pregnancy.
• Presence of local or systemic infection.