Cervical Spine Radiculopathy , Spurling's Test - Everything You Need To Know - Dr. Nabil Ebraheim

Dr. Ebraheim's animated educational video describing the Spurling's Test - cervical spine radiculopathy.
The Spurling's Test is a physical exam provocative test. The Spurling's Test is used frequently to asses cervical nerve root impingement or irritation. The Spurling's Test is specific for evaluation of the cervical nerve roots.
The patient will come to the doctor with the complaint of neck pain. If the pain is due to nerve root irritation with eh pain radiating to the ipsilateral upper extremity, the doctor will try to see if the patient has a cervical disc herniation with irritation of the nerve root.
Keep in mind that cervical spine problems and shoulder problems overlap. The doctor will exam the patient carefully. Each nerve that is involved will show its effect on the motor power, the sensation and reflexes.
Motor C7: elbow extension, wrist flexion, finger extension.
Reflexes C7: triceps reflex
Herniated C6-C7 bulge
Each level will get the nerve to the lower number. Herniation at the level of C5-C6 will get the C6 nerve root.
Sensory C6
C6 wrist extension (extensor carpi radials longus and brevis
Biceps C5, C6
Reflexes C6: brachioradialis reflex
Herniated C6-C7 bulge
Sensory C7
Motor: triceps C7, wrist flexion, finger extension.
Reflexes: C7 triceps reflex
There are some other tests for cervical spine radiculopathy which are called provocative test.
The Spurling's Test is performed to assess cervical nerve root pain and impingement. The clinician will be standing behind the patient. the patient can be sitting down or standing up. there should be extension, lateral flexion and some rotation of the neck towards the affected side. Downward compressive force to the top of the patient’s head is applied (Axial loading). A positive test will reproduce the pain in the upper extremity when the compressive force is applied. A positive test causes radiating pain down the patient’s arm. Radiating pain will be attributed to the nerve root impingement or compression on the same side (ipsilateral side).
Shoulder abduction test
The shoulder abduction test is different. The patient’s symptoms are relived by shoulder abduction, by placing the hand over the head. This test helps to differentiate between cervical spine pathology and other causes of shoulder pain. It is an important test for cervical radicular compressive diseases. The relief of the symptoms occurs due to decreased tension on the nerve roots. If there is a relief of symptoms by shoulder abduction, then the cause of shoulder pain is not a shoulder pathology, but it is pain that is probably coming from cervical nerve root pathology due to nerve irritation. These patients with cervical nerve root irritation could be treated conservatively up to 3 months with therapy, nonsteroidal anti-inflammatory drugs (NSAIDs) and 75% of these patients will improve with non-operative treatment.
When should you do surgery?
If the patient has persistent pain for 6-12 weeks
If there is progressive neurological deficit.
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[@SD-yb5fx]

Yes, your video is very helpful and it is exactly in line with my neurosurgeon diagnosis. May I add, that I especially like you speaking in the video and no music playing.

[@HayTatsuko]

Thank you very much for this informative, well-presented video. I will be seeing a specialist about my own case soon, but it was very interesting to learn about the shoulder abduction test: I already stumbled across that gesture on my own, finding it to provide some relief when I am trying to sleep.

[@sansanchang781]

Dr. Nabil Ebrahim, thank you very much, I can learn from you!

[@edlan1860]

Thanks a lot for this great, very instructive video!

[@probios]

Thank you! Your videos are very informative and helpful!

[@claireshin7239]

Thank you! very helpful

[@JacquelineClayton777]

Thank you for your very clear and informative video.

[@belbachirdjamel8906]

thank you.

[@ileanahernandez]

thank you very much, it`s a great video, very, very useful

[@almouazzen]

Great vedio thanks.

[@charlesmunyoro633]

Wow. Super. Thanks

[@Bageera63]

Are you reading my medical notes telepathically? Cervical ESI x 3 helped me. So far so good!

[@MahadevaGlobalMedicalCenter]

Excellent information-Thank you

[@bassem9545]

Thanks, great video

[@mohammadsuleiman]

ألشكر الجزيل لكم حضرة الطبيب على كل شروحاتكم في كل مقاطع الفيديو التي عرضتموها .

[@medicineislove148]

Thankssss so much

[@shrilhan4921]

Thanks

[@uzmafaheem4573]

Thank you very much for this informative video.

[@ritikaritika727]

Mashallah very nicely explained 👏

[@hayathallouche1069]

Thank u sir very useful

[@netarman]

Great

[@1janitra]

Jazakallah!

[@sangeethasgsg9691]

Super sir

[@ruichaocheng]

dope, doc, thanks a lot

[@samiraltalafha5641]

انت رائع يا دكتور لو كل فيديوهات تشيل الموسيقى وتشرح بنفس الطريقة

[@lorilori4703]

Thank you for your help. I have ² questions if you wouldn't mind helping me What happens if left untreated? When to seek medical treatment my pain is going all the way from my rightside neck toshoulder middle back and my middle fingers especially the bicep cant left much or my arm gives out when I do definitely effecting coordination and weakness nsaid and muscle relaxers barely ease the pain I already had have optic nerve damage aswell on the left side neck from trauma I need some advise no doctor around me seems to know whats happening to me just called it. Inflammation because ctscan showed the effected area was very inflamed no further testing has been done I don't know what to do can you help me with this please Dr.Nabil Ebraheim can please give me some much-needed guidance ? I'm desperate im only 31 and have a 2 yearimust take care of full time by myself this is my dominate arm and the pain is unlike anything ive experienced 😢

[@teferitecle9899]

Second to None illustration!!!

[@yolandarivera7952]

Thats so bad am a serguty or disck bod recupation is cracy pain everytin change in a life

[@BusinessWithGwd]

Age 18 M:My neck got traumatised 1 year back and i felt very dizzy for almost 5 months and it got ended and then comes to neck pain started after this episode having left arm weakness(Radiating till fingers)frequently and rarely right one and feeling like something is flowing in my cervical spine gonna be feeling like blood flow and pulsations all over my body ( mainly in the abdomen and are clearly visible …and shoulder pain and The Major one is My arms aren’t equal like the right one is little lower than the left one plz help me with this

[@ranchimedicocity1731]

❤ tysm plz support

[@belbachirdjamel8906]

thank you.

[@mohiuddinalfarra5440]

Thanks