Vertical weight-bearing MRI provides an innovative method for standardizing Spurling test

Although Spurling test, a foraminal compression test, is commonly used in clinical practice in patients with a suspected cervical radiculopathy, its protocol is still obscure. In undergoing this test, patients extend, laterally flex and slightly rotate neck to the symptomatic side, and then a pressure is applied on the top of patient's head by examiner. The test is scored as positive if it causes pain or tingling that starts in the shoulder and radiates distally to the elbow. But the range of neck motion and level of load are not clearly defined. Magnetic resonance imaging (MRI) has proved to be an excellent method of assessing the situation of cervical intervertebral foramen. Unfortunately the conventional MRI system is not able to fully achieve this goal because it can only examine patient in supine position while Spurling test needs to be performed in a sitting position. Here we hypothesize that vertical weight-bearing MRI provides an innovative method for researching and standardizing the protocols of Spurling test. The result will provide better knowledge of the mechanism of Spurling test. Standardization of the test will improve its sensitivity and rate of reproducibility.