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Spurling's Compression Test
Spurling's Compression Test is a test conducted to assess the presence of spinal nerve root compression. It involves pressing the head in different directions while the patient is in a seated or supine position. The test assesses pain and nerve root compression symptoms that originate from the upper cervical spine. Spurling’s Compression Test can also be used to diagnose cervical radiculopathies (C7-C8).
Transcript
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This is Brent of the Brookbush Institute and in this
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video we're going to do Spurling's
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compression test for cervical radiculopathy. I'm going to have my friend
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Yvette come out, she's going to help me demonstrate. Now we're going to assume that
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Yvette came in and she was complaining about some neck pain, and maybe she
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described some feelings that we're thinking might have something to do with
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some nerve irritation. So Yvette why don't you let me know are you having any
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symptoms right now? (No). All right which side were you having symptoms on? (Left). Okay so
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that's the first thing we want to do is make sure we have a good idea of what's
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going on in this position. So now she's having symptoms on her left side,
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we're going to see if we can make them worse by laterally flexing to the left
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side. So go ahead and start over again, notice she was actually very
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good, your patients are going to have a tendency to, go ahead and slouch for me,
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so like there you go, and then I'm going to go side bend, and you what would you do,
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just like this, and they like get that forward head side bend rotation combination. So
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make sure you are trying to be as reliable as possible in the sense that
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you're trying to define the test, make the test the same way every time. If you
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wanted to come back and reassess this particular test, you want to make sure
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that you know you don't test it in slouched position one time and then get
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all strict about form the next time, that's not going to help your reliability.
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So I'm going to make sure she's sitting up nice and tall,
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check her symptoms in this position, she's not having any but she says the
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history of her symptoms is on the left side. So I'm going to have her side bend to
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the left and does that bring on your symptoms? No so that doesn't bring on her
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symptoms. So far she's still negative but we have one more step and that's to
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side bend to the left and now I'm going to add overpressure. For those of
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you who know some stuff about joint exams and stuff you're very used
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to overpressure, I'm actually going to hold her this way so I can
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control her torso a little bit with my elbows, and I'm going to compress
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and laterally flex a little bit. So I'm pushing her head into this position
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while pushing straight down into compression, and if she still doesn't
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have symptoms, Yvette no symptoms? (No). Then this test is negative. If lateral
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flexion to the left or overpressure bring on her symptoms then this test is
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positive. So let's go over that one more time, sit up nice and tall. Check their
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symptoms, make sure that they're not currently having symptoms, laterally
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flex to the left, great. Once they've laterally flexed to the left did that make
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it worse? If that didn't it make it worse you're going to check with overpressure. Now
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how are we going to weigh this test, well this test is more specific than
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sensitive. In fact it's not particularly sensitive at all. So if I get a negative
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on this test it wouldn't rule out cervical radiculopathy just yet, I'm
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going to use a few more tests inside of a cluster to make sure that I am as
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accurate as I can be. If I have a positive on this test though I might start to
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seriously think cervical radiculopathy is a potential diagnosis, being that this
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test is specific a yes, a positive has far more weight. So there you have it,
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Spurling's compression test. We are going to add this to a cluster of tests which
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we'll talk about in a later video, this is more specific than sensitive. If you
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