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Spurling's Test


Name
Purpose1,2
Description1,2,3
Sensitivity, Specificity
Reliability
Likelihood Ratio +/-
Spurling’s Test
 aka Foraminal Compression Test
A positive test of pain radiating into the upper extremity towards the same side that the head is laterally flexed would indicate pressure on the nerve root.
The patient should be seated with their neck side bent/rotated towards the ipsilateral side. The examiner should then carefully provide a compression force straight through the head to determine if symptoms are provoked. Repeat on the opposite side. This test could be performed with 3 different steps involving the head in neutral, extension, or extension with rotation
Sensitivity=
.304-.935
Specificity=
.746-.955
 
Inter-examiner
 K=
.287-.778
LR+ =
1.96-18.65
LR- =
.075-.754

1.       Konin JG, Wiksten DL, Isear Jr. JA, Brader H. Special Tests for Orthopedic Examination. 3rd ed. Thorofare, NJ: SLACK incorporated; 2006.
2.       Magee DJ.  Orthopedic Physical Assessment. 5th ed. St. Louis, MO: Saunders Elsevier; 2008.
3.       Cleland JA, Koppenhaver S. Netter’s Orthopaedic Clinical Examination: An evidence-based approach. 2nd ed. Philadelphia, PA: Saunders Elsevier; 2011.
4.       Tong HC, Haig AJ, Yamakawa K. The Spurling test and cervical radiculopathy. Spine. 2002; 27: 156-159.
5.       Shah KC, Rajshekhar V. Reliability of diagnosis of soft cervical disc prolapse using Spurling’s test. Br J Neuro-surg. 2004; 18: 480-483.
6.       Wainner RS, Fritz JM, Irrgang JJ Boninger ML, Delitto A, Allison S. Reliability and diagnostic accuracy of the clinical examination and patient self-report measures for cervical radiculopathy. Spine. 2003; 28:52-62.
7.       Bertilson BC, Grunnesjo M, Strender LE. Reliability of clinical tests in the assessment of patients with neck/shoulder problems-impact of history. Spine. 2003;28: 2222-2231.
8.       Viikari-Juntura E. Interexaminer reliability of observations in physical examinations of the neck. Phys Ther. 1987;67:1526-1532.