Omar sign update for the clinical diagnosis of unilateral lumbar foraminal stenosis

Abstract Objective and study design A retrospective study analyzes the validity of Omar’s sign for the clinical diagnosis of unilateral lumbar foraminal stenosis. Methods This study analyses 800 patients having unilateral leg pain due to lumbar foraminal stenosis, between 2011 and 2025. All the data were obtained from the database collected at my institution and private clinics. All patients underwent a standardized neurological assessment using the Omar test during their clinical examinations and then were compared with the MRI and postoperative findings. Results The test was 100% positive, with high sensitivity for unilateral lumbar disc prolapse and foraminal stenosis. This high sensitivity is associated with only 40% specificity for selective nerve root compression. There is a strong correlation between the test and the lumbar spine MRI. Conclusion Omar’s test and sign is a reliable clinical diagnostic test for lumbar foraminal stenosis diagnosis, especially secondary to disc prolapse. Its high sensitivity, with strong correlation with MRI, makes it a valuable additional test to the neurological examination and for follow-up application after foraminal decompression surgery.