CPR for Cervical Radiculopathy

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Original Editor - Ben Lippe

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Purpose

 To assist in ruling in or out the diagnosis of cervical radiculopathy.

The Rule

 The following criteria are considered predictive of the presence of cervical radiculopathy:  positive upper limb tension test A (ULTTa), involved-side cervical rotation range of motion less than 60 degrees, positive distraction test, and positive Spurling's test A.  Definitions of posititive provocative test results are as follows:

1. ULTTa: Any one of the following:  A) symptom reproduction; B) side-to-side difference >10 degrees in in elbow extension; or C) with regard to involved/painful side, ipsilateral neck lateral flexion decreases symptoms and/or contralateral neck lateral flexion increases symptoms.

2. Distraction test:  symptom reduction.

3. Spurling's A:  symptom reproduction.

 Clinical values of results are as follows:

Number of Positive Criteria	Sensitivity (95% CI)	Specificity (95% CI)	Positive LR	Negative LR*
Two	0.39 (0.16-0.61)	0.56 (0.43-0.68)	0.88 (1.5-2.5)	1.09
Three	0.39 (0.16-0.61)	0.94 (0.88-1.0)	6.1 (2.0-18.6)	0.65
Four	0.24 (0.05-0.43)	0.99 (0.97-1.0)	30.3 (1.7-538.2)	0.77

 (Table adapted from Wainner et al 2003.  *Calculated from Sn and Sp values provided in Wainner et al 2003.)

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References

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