Diagnostic Performance of Spurling's Test for the Assessment Sub-acute and Chronic Cervical Radiculopathy: A Systematic Review and Meta-Analysis.
Journal
American journal of physical medicine & rehabilitation
ISSN
1537-7385
Date Issued
2025-02-04
Author(s)
Abstract
Spurling's test (ST) is commonly used to diagnose cervical radiculopathy (CR); however, its diagnostic accuracy varies across studies. This systematic review and meta-analysis aim to evaluate the diagnostic performance of ST for CR. A systematic search of PubMed, ClinicalTrials.gov, Cochrane Library, and Physiotherapy Database was conducted following PRISMA guidelines. Studies assessing ST against imaging or electrodiagnostic tests were included. A bivariate random-effects model calculated pooled sensitivity, specificity, likelihood ratios (LR), and log diagnostic odds ratios. Eight studies met the inclusion criteria. The pooled sensitivity of ST was 0.53 (95% confidence interval [CI]: 0.29-0.78), higher with imaging (0.67) than with electrodiagnostic testing (0.31). Combining neck rotation or extension increased sensitivity to 0.67, compared to 0.31 without. The pooled specificity was 0.92 (95% CI: 0.88-0.96), 0.93 with imaging and 0.91 with electrodiagnostic testing. The pooled positive LR was 3.28, negative LR was 0.28, and the log diagnostic odds ratio was 2.74. ST is highly specific but has low sensitivity for CR diagnosis, making it better suited for confirmation than screening. Sensitivity may improve with added maneuvers and imaging as a reference.
Type
journal article