Exams for cervical radiculopathy

Discover how to excel in the Clinic Readiness Test. Dive into detailed flashcards and multiple choice questions. Elevate your readiness for the evaluation with insightful hints and descriptions.

Cervical radiculopathy is nerve-root irritation caused by compression as the nerve exits the cervical spinal canal. To confirm this, we use provocative tests that stress the nerve roots and see if arm symptoms are reproduced.

Spurling’s test (with its variations) does exactly that by compressing the neural foramina where the nerve roots exit the spine. In the basic version, the clinician applies downward pressure on the head (often with a bit of side-bending of the neck). In the extended version, neck extension and rotation are added to further narrow the foramina. If this maneuver reproduces the patient’s familiar arm radicular pain, it strongly suggests cervical nerve-root compression, such as from foraminal stenosis or a disc herniation.

This makes it the best choice among the options because it directly provokes the nerve roots and provides specific evidence of radiculopathy. The other tests have different roles: distraction tests assess whether symptoms improve when space is opened but don’t directly provoke the root; upper limb neural tension tests (ULNT) evaluate nerve tension along the arm but are less specific to the cervical root level; Bakody’s sign reduces nerve tension by abduction of the arm and can suggest radiculopathy but is less direct in provoking the root compared to Spurling’s test.