Cervical Radiculopathy

Spurling Test

Spurlings Test: The patient is seated and lateral flexes + extends the cervical spine.  The practitioner applies axial pressure through the top of the head.  A + test is reproduction of radicular pain or numbness down the UE.  Sensativity: 30%,  Specificity: 93%

Tong H,   Haig AJ, Yamakawa K. The Spurling Test and Cervical Radiculopathy. Spine; 27: 156-59.

Distraction Test: Patient is supine and examiner applies a traction force to the cervical spine.  A + test is resolution of symptoms. Sensativity:44%  Specificity:90%

ULTT median nerve bias

Upper Limb Tension Test: Patient is supine and clinician depresses the shoulder girdle, abducts the humerus to 110 degrees, supinates the forearm and extends the elbow,wrist and fingers.  The cervical spine is then sidebent away from the tested UE. A + test is reproduction of symptoms. Sensativity: 97%, Specificity: 22%

Cluster diagnosis for cervical radiculopathy

Wainner et al found a 99% specificity and + likehood ratio of 30.3 for cervical radiculopathy when a patient had:

  1. + ULTT of median nerve
  2. cervical rotation < 60deg
  3. + Distraction Test
  4. + Spurlings Test

Wainner RS, Irrgang JJ, Delitto A. Reliability and Diagnostic Accuracy of the Clinical Examination and Patients Self-Report Measures for Cervical Radiculopathy. Spine; 28: 52-62.