Spurling's test

The Spurling test is a medical maneuver used to assess nerve root pain (also known as radicular pain). The examiner turns the patient's head to the affected side while extending and applying downward pressure to the top of the patient's head. A positive Spurling's sign is when the pain arising in the neck radiates in the direction of the corresponding dermatome ipsilaterally. It is a type of cervical compression test.

Patients with a positive Spurling's sign can present with a variety of symptoms, including pain, numbness and weakness. In addition to the clinical history, the neurological examination may show signs suggesting a cervical radiculopathy.

Accuracy

Spurling's test is somewhat specific when used for individuals with an abnormal electromyogram study and is a relatively sensitive physical examination maneuver in diagnosing cervical spondylosis or acute cervical radiculopathy. It is not a very sensitive test when used for individuals without classic radicular signs suggestive of cervical radiculopathy. In 2011, one study evaluated 257 patients with clinical cervical radiculopathy and correlated CT scan findings with clinical exam findings using the Spurling's test. The Spurling's test was 95% sensitive and 94% specific for diagnosing nerve root pathology.^[1]

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