Cervical Spine Orthopedics I Practice Exam

A practical approach for suspected cervical radiculopathy uses a small cluster of provocative, nerve-root–sensitizing tests at the bedside. The goal is to reproduce the patient’s radicular symptoms and localize irritation to a cervical nerve root, supporting degenerative foraminal compression from spondylosis. Upper limb tension tests check neural tissue sensitivity along the brachial plexus and nerve roots, so a positive result suggests nerve-root irritation rather than pure joint pain. Spurling’s test directly loads the foraminal space to provoke radicular pain when a compressed nerve root is present, helping localize the problem to neural impingement. The distraction test unloads the cervical spine and foraminal space; relief of symptoms with distraction strongly supports radiculopathy due to nerve compression rather than non-neurologic neck pain. A cervical range of motion limited to the ipsilateral side, particularly with rotation reduced to about 60 degrees or less, further points to mechanical impingement at the level affecting the nerve root. Together, these maneuvers form a useful initial screen because they are quick, noninvasive, and increase diagnostic confidence for nerve-root involvement before imaging. By contrast, signs like Lhermitte, Hoffman, or Babinski lean toward myelopathy or central nervous system involvement rather than radiculopathy, and imaging studies (MRI, CT, X-ray, ultrasound) provide structural information rather than a primary, bedside diagnostic cluster.