What is Spurling Test?
- Spurling Test is a musculoskeletal assessment of the cervical spine when looking for cervical nerve root compression causing cervical radiculopathy.
How it's Performed?
- The patient is seated and asked to sidebend and slightly rotate head to the painful side.
- The clinician places a compressive force of approximately 7 kg through the top of the head in an effort to further narrow the intervertebral foramen.
- If the patient tolerates this initial step of the test, it is then repeated with the cervical spine extended as well.
What does a positive Spurling Test mean?
- The Spurling test is considered positive when it reproduces the patient’s symptoms. The test is not indicated if the patient does not have upper extremity or scapular region symptoms.
- Simultaneous extension of the cervical spine narrows the intervertebral foramina by 20 to 30%.
- In conditions such as cervical stenosis, spondylosis, osteophytes, trophic facet joints, or herniated disks, the foramina may already be smaller than norm al.
- The test is not considered to be positive if there is neck pain only, without radiation into the shoulder or arm.
- Pain radiating to the arm specific to a certain dermatome suggests nerve root irritation.
- Pain that is already present w ill be increased by this movement. Myalgia and whiplash syndrome can cause pain on the opposite side.
- This is called a reverse Spurling sign and suggests pain on the side of muscles that have been stretched from muscle strain or functional disturbance with muscle foreshortening.
Sensitivity & Specificity
- Sensitivity: 95 %
- Specificity: 94 %
- Pain on the concave side indicates nerve root irritation or facet joint pathology (Spurling sign).
- Pain on the convex side indicates muscle strain (reverse Spurling sign).
- The Spurling test is an aggressive cervical compression test, and the patient should be prepared for each step of the examination.
- The test should not be performed when cervical fracture, dislocation, or instability are suspected.
- Campbel's Operative Orthopaedics 13th Book
- Research Gate
- Clinical Tests for the Musculoskeletal 3rd Ed. Book
- Shabat, Shay; Leitner, Yossi; David, Rami; Folman, Yoram (September 2011). "The Correlation between Spurling Test and Imaging Studies in Detecting Cervical Radiculopathy". Journal of Neuroimaging. 22: 375–378. doi:10.1111/j.1552-6569.2011.00644.x. PMID 21883627
- Steven J. Jones1; John-Mark M. Miller2. Spurling Test. Treasure Island (FL): StatPearls Publishing; 2019 Jan-3. Tong HC1, Haig AJ, Yamakawa K. The Spurling test and cervical radiculopathy. Spine (Phila Pa 1976). 2002 Jan 15;27(2):156-9.