Unit of Spinal Surgery, Sapir Medical Center, Israel and Tel-Aviv Sackler Medical Faculty, Tel-Aviv, Israel.
J Neuroimaging. 2012 Oct;22(4):375-8. doi: 10.1111/j.1552-6569.2011.00644.x. Epub 2011 Sep 1.
Cervical spine symptoms are a major cause of visits to general or spinal orthopedic surgeons or even primary care physicians. Although in this era the imaging studies can precisely rule out or diagnose pathologies in the spine, all of these studies have limitations. Computerized tomography (CT) scan consists of radiation exposure to the patients and it should be done with caution. Magnetic resonance imaging (MRI) is a highly effective imaging tool, but in many countries it is still costly. The goal of our study was to determine whether a simple clinical test can help the clinician to identify the patients who need to be sent for these imaging studies.
Two hundred fifty-seven patients with clinical cervical radiculopathy underwent complete physical examination that also included the Spurling test. After that, all patients were sent to imaging studies of the cervical spine (CT and/or MRI). Correlation between the physical examination using the Spurling test to the imaging studies was done.
Sensitivity of the Spurling test to nerve root pathology was 95% and specificity was 94%.
This paper demonstrate that patients with positive Spurling test have probable nerve root pressure and should be sent for further imaging studies. In patients with negative Spurling test, the possibility of nerve root pressure is less likely.
颈椎症状是导致普通外科或脊柱骨科医生，甚至初级保健医生就诊的主要原因。尽管在这个时代，影像学研究可以精确地排除或诊断脊柱病变，但所有这些研究都有其局限性。计算机断层扫描（CT）检查会使患者受到辐射，因此应谨慎进行。磁共振成像（MRI）是一种非常有效的成像工具，但在许多国家，它仍然很昂贵。我们的研究目的是确定是否有一种简单的临床测试可以帮助临床医生识别需要进行这些影像学研究的患者。
257 例有临床颈椎神经根病的患者接受了完整的体格检查，其中还包括 Spurling 试验。之后，所有患者都被送往颈椎影像学检查（CT 和/或 MRI）。对 Spurling 试验的体格检查与影像学研究进行了相关性分析。
Spurling 试验对神经根病变的敏感性为 95%，特异性为 94%。
本文表明，Spurling 试验阳性的患者可能有神经根受压，应进一步进行影像学研究。Spurling 试验阴性的患者，神经根受压的可能性较小。
