The Correlation between Spurling Test and Imaging Studies in Detecting Cervical Radiculopathy

Shabat, Shay; Leitner, Yossi; David, Rami; Folman, Yoram

doi:10.1111/j.1552-6569.2011.00644.x

Cited by 46 publications

(25 citation statements)

References 12 publications

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“…Several reports have established a clear causal relationship between a positive Spurling test and the presence of cervical root compression, evident either on radiographs [24] or in electrodiagnostic studies [29]. The decreased VAS score and dissimilar pain distribution reported in the control group with spondylosis compared with the study group corroborate with previous findings.…”

Section: Discussionsupporting

confidence: 83%

What is the Best Way to Apply the Spurling Test for Cervical Radiculopathy?

Anekstein

Blecher

Smorgick

et al. 2012

Clinical Orthopaedics &Amp; Related Research

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Background A diagnosis of cervical radiculopathy is based largely on clinical examination, including provocative testing. The most common maneuver was described in 1944 by Spurling and Scoville. Since then, several modifications of the original maneuver have been proposed to improve its value in the diagnosis of cervical radiculopathy. Questions/Purposes We assessed the ability of six known variations of the Spurling test to reproduce the complaints of patients diagnosed with cervical radiculopathy. Methods We prospectively enrolled 67 patients presenting with cervical radicular-like symptoms and concordant radiographic findings. Each patient underwent six distinct provocative cervical spine maneuvers by two examiners, during which three parameters were recorded: (1) pain intensity (VAS score), (2) paresthesia intensity (0 -no paresthesia, 1 -mild to moderate, and 2 -severe), and (3) characteristic pain distribution (0 -no pain, 1 -neck pain only, 2 -arm pain only, 3 -pain elicited distal to the elbow). The interobserver reliability of the reported VAS score (measured by the intraclass coefficient correlation) ranged from 0.78 to 0.96 and the calculated kappa values of the categorical parameters ranged from 0.58 to 1.0 for paresthesia intensity and from 0.63 to 1.0 for pain distribution. Differences in scores elicited between the two examiners for the 67 patients were resolved by consensus. Results A maneuver consisting of extension, lateral bending, and axial compression resulted in the highest VAS score (mean, 7) and was associated with the most distally elicited pain on average (mean, 2.5). The highest paresthesia levels were reported after applying extension, rotation, and axial compression (mean, 1). These maneuvers, however, were the least tolerable, causing discontinuation of the examination on three occasions. Conclusions Whenever cervical radiculopathy is suspected our observations suggest the staged provocative maneuvers that should be included in the physical evaluation are extension and lateral bending first, followed by the addition of axial compression in cases with an inconclusive effect. Level of Evidence Level II, diagnostic study. See the Guidelines for Authors for a complete description of levels of evidence.

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Section: Discussionsupporting

confidence: 83%

What is the Best Way to Apply the Spurling Test for Cervical Radiculopathy?

Anekstein

Blecher

Smorgick

et al. 2012

Clinical Orthopaedics &Amp; Related Research

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“…The diagnosis of cervico-brachialgia was made on the basis of an accurate physical examination, performed by the most expert of the Authors (SG), including: evaluation of range of motion (ROM); four clinical tests with an high accuracy for cervical radiculopathy: Spurling test, shoulder abduction test, Valsalva manueuver, traction/neck distraction test [5][6][7][8][9][10], Arm Squeeze test [11] and motor, sensory and reflex examination. Inclusion criteria for all participants were: clinical diagnosis of cervical radiculopathy; onset of disturbs from less than six months; age ≥ 40 years; signs of chronic damage on needle electromyography (EMG) and nerve conduction studies (NCS).…”

Section: Methodsmentioning

confidence: 99%

Shoulder pain due to cervical radiculopathy: an underestimated long-term complication of herpes zoster virus reactivation?

Gumina

Candela

Passaretti

et al. 2017

International Orthopaedics (SICOT)

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“…A detailed history, clinical examination and functional tests may be helpful in confirming the etiology of cervical chest pain 7 . Despite being first described in 1934, the diagnosis of cervical chest pain remain under recognized 18 . Most cases of cervical spondylosis with radiculopathy treatment are conservative.…”

Section: Discussionmentioning

confidence: 99%

Clinico-Demographic Characteristics of Cervical Spondylosis Patients Presented with Chest Pain

Hafez

Yusuf

Nessa³

et al. 2018

J Curr Adv Med Res

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The Correlation between Spurling Test and Imaging Studies in Detecting Cervical Radiculopathy

Abstract: This paper demonstrate that patients with positive Spurling test have probable nerve root pressure and should be sent for further imaging studies. In patients with negative Spurling test, the possibility of nerve root pressure is less likely.

Cited by 46 publications

References 12 publications

What is the Best Way to Apply the Spurling Test for Cervical Radiculopathy?

What is the Best Way to Apply the Spurling Test for Cervical Radiculopathy?

Shoulder pain due to cervical radiculopathy: an underestimated long-term complication of herpes zoster virus reactivation?

Clinico-Demographic Characteristics of Cervical Spondylosis Patients Presented with Chest Pain

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