Study design: A case is reported of L3-L4 far lateral disc herniation, in which the femoral stretching and crossed femoral stretching tests were positive.
Objectives: To discuss the clinical usefulness and pathophysiologic mechanics of the femoral and crossed femoral nerve stretching tests.
Summary of background data: The femoral and crossed femoral stretching tests have received little clinical and research attention. The validity of these two nerve root tension signs to evaluate upper disc herniations remains unknown.
Methods: A 73-year-old woman presented with progressive low back pain and left anterolateral thigh pain of 2 months duration. The diagnosis of far lateral disc herniation at L3-L4 was initially suspected from a positive crossed femoral nerve stretch. An open discectomy was performed without complications.
Results: Eight months after surgery, the patient had recovered and the femoral and crossed femoral stretching tests were negative.
Conclusions: It is hypothesized that the crossed femoral stretching test may be a valid maneuver to help in the diagnosis of symptomatic disc herniation above L4.