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Eur Spine J (2013) 22:15221525 DOI 10.1007/s00586-013-2689-5
ORIGINAL ARTICLE
Abduction extension cervical nerve root stress test: anatomical basis and clinical relevance
M. Farshad K. Min
Received: 2 September 2012 / Revised: 28 November 2012 / Accepted: 25 January 2013 / Published online: 15 February 2013 Springer-Verlag Berlin Heidelberg 2013
AbstractPurpose While the Lasgue straight leg raising test is an established test for lumbar nerve root compression, an established equivalent for cervical nerve root compression is missing. The aim of this bi-modal study was to nd the most effective way to stretch the cervical nerve roots anatomically in cadavers and to assess its value in the clinical setting.
Methods Three positional maneuvers of the upper limb were tested on three cadavers to determine the displacement by stretch of the nerve roots C5, C6 and C7. The maneuver which was most efcient in nerve root displacement was applied in 24 patients with conrmed symptomatic cervical nerve root compression (cases) and 65 controls to assess the clinical value of the test.Results The most efcient way to displace the cervical nerve roots by stretch was to apply dorsal pressure on the humeral head with the shoulder in 80 of abduction and 30
of extension, with slight elbow exion while the head is facing the contralateral side. This maneuver produced 45 mm of nerve root displacement in cadavers. This test aggravated radicular symptoms in 79 % of the patients with cervical nerve root compression and was negative in 98 % of the controls.
Conclusion The described abduction extension test with posterior push on the humeral head creates a fulcrum over which the brachial plexus can be displaced to create stress on cervical nerve roots. This simple test is easy to perform clinically and aggravates radicular symptoms in most of the
patients with cervical nerve root compression while it is negative in nearly all of the controls.
Keywords Cervical radiculopathy Clinical test
Root stretch
Introduction
While the straight leg test, also known as the Lasgue test is used commonly when lumbar nerve root compression is suspected [1], its equivalent for cervical radiculopathy is not yet established. The straight leg test is known to have a valuable sensitivity with however a low specicity in the diagnosis of lumbar nerve compression [1, 2]....