Accuration of laseque test compared with myelographyas diagnostic test in nucleus pulposus hernia pa
ABSTRACT
O.S Hartanto, Rusdi Lamsudin, Samekto Wibowo, Imam Rusdi - Accuration of laseque test compared with myelographyas diagnostic test in nucleus pulposus hernia patients
Backgroud: Almost all of adults have suffered from low back pain; one of the cause of the back pain is nucleus pulposus hernia (HNP), The gold standard for the diagnosing HNP is myelography; CT scanning as diagnostic test for HNP is expansive and maybe done only in certain hospitals. Myelography as diagnostic test for HNP required invasive expensive procedure, the lasque test as non invasive diagnostic test for HNP, easily to be applied, cheap and may be done everywhere. Objective: Proving that the laseque test is an accurate diagnostic test for diagnosing lumbosacral HNP. Method: The design of this study is diagnostic test. The study was done in Sardjito Hospital, Yogyakarta. Subjects were 20 70 years old, who suspected had HNP. Myelography was used in this study as control as well as gold standard (sensitivity 90%, spesifrty 87%). Statistical analysis: sensitivity, spesifity and accuracy test were determined and compared with myelography using Q square. Result: During 18 months (from November 1990 until July 1992) were found 180 subjects according to the determined criterias. After myelography procedure, there were 42 patients with HNP at L5-S1 and 52 patients with HNP at L4-5 (94 patients were HNP positive and 86 patients were HNP negative). Laseque test was done to all subjects proceeding the study. Statistical analysis for laseque test with angle 30, positive predictive value 72,72%, negative predictive value 44, 20%, sensitivity 17,02%, specifity 93,02%, prevalence 12,22%, accuracy 53,33%. Statistical analysis for the laseque test 60%, positive predictive value 61,67%, negative predictive value 0,48%, sensitivity 91, 46%, specifity 38, 37%, prevalence 77,22%, accuracy 66,11%. Statistical analysis for the laseque test 90%, positive predictive value 56, 25%, negative predictive value 80%, sensitivity 95, 74%, specifity 18,6%, prevalence 88,88%, accuracy 58,88%.
Conclusion : The laseque 60° examination has high sensitivity but less spesific, while has the highest accuracy among the other laseque test with different angle. This test may be used for detecting HNP in the place where radiologic fasilities were not availabe.
Key words; pain-nucleus pulposus hernia- myelography-diagnostic test-laseque test