Test: Spurling

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Background/Purpose

Reproduction of radicular symptoms suggests nerve root compression. Localized spinal pain suggests facet involvement. A vertical blow is delivered to the uppermost portion of the cranium. The examiner may wish to interpose a hand between the concussing hand and the patient’s skull. The head and neck are first in neutral position for this procedure and then positioned into lateral flexion and extension for a repeated procedure. The test will stimulate any nerve root irritation or other pain-sensitive structures related

Procedure

While seated comfortably and with an erect posture, the patient actively rotates the head from side to side. Localization of pain is noted. The patient’s head is laterally flexed toward the side of complaint. The examiner applies gradually progressive downward pressure to the head and neck. The balance of the test should not be completed. From the laterally flexed position, the neck is extended as far as the patient can tolerate. The examiner applies progressive downward pressure.
Performed: Unilaterally

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Assessment for cervical nerve root compression syndrome

Criteria

• Reproduction of symptoms or collapse sign at this point constitutes a positive test. Reproduction of radicular symptoms suggests nerve root compression.

Measurement

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LOINC Code

0

Scale/Grading

Pass/Fail