Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2017 Jun 23;14(7):662-667.
doi: 10.7150/ijms.19110. eCollection 2017.

Diagnostic Accuracy of the Neck Tornado Test as a New Screening Test in Cervical Radiculopathy

Juyeon Park  1 , Woo Young Park  2   3 , Seungbae Hong  4 , Jiwon An  5 , Jae Chul Koh  6 , Youn-Woo Lee  5 , Yong Chan Kim  7 , Jong Bum Choi  4
Affiliations

Diagnostic Accuracy of the Neck Tornado Test as a New Screening Test in Cervical Radiculopathy

Juyeon Park et al. Int J Med Sci. .

Abstract

Background: The Spurling test, although a highly specific provocative test of the cervical spine in cervical radiculopathy (CR), has low to moderate sensitivity. Thus, we introduced the neck tornado test (NTT) to examine the neck and the cervical spine in CR.

Objectives: The aim of this study was to introduce a new provocative test, the NTT, and compare the diagnostic accuracy with a widely accepted provocative test, the Spurling test.

Design: Retrospective study.

Methods: Medical records of 135 subjects with neck pain (CR, n = 67; without CR, n = 68) who had undergone cervical spine magnetic resonance imaging and been referred to the pain clinic between September 2014 and August 2015 were reviewed. Both the Spurling test and NTT were performed in all patients by expert examiners. Sensitivity, specificity, and accuracy were compared for both the Spurling test and the NTT.

Results: The sensitivity of the Spurling test and the NTT was 55.22% and 85.07% (P < 0.0001); specificity, 98.53% and 86.76% (P = 0.0026); accuracy, 77.04% and 85.93% (P = 0.0423), respectively.

Conclusions: The NTT is more sensitive with superior diagnostic accuracy for CR diagnosed by magnetic resonance imaging than the Spurling test.

Keywords: Spurling test; cervical radiculopathy; neck pain; neck tornado test.; radicular pain.

PubMed Disclaimer

Conflict of interest statement

Competing Interests: The authors have declared that no competing interest exists.

Figures

Figure 1
Figure 1
The Spurling test. Neck extension and lateral bending were performed.
Figure 2
Figure 2
The force to exacerbate the encroachment of the exiting nerve roots was only applied at a single direction. The Spurling test was negative in (A) and (C) and positive in (B).
Figure 3
Figure 3
Force is applied at all angles by rotating the neck in a 180° tornadic pattern.
Figure 4
Figure 4
The neck tornado test (Choi's test).
Figure 5
Figure 5
ROC curves of the Spurling test and the NTT. ROC: receiver operating characteristic; NTT: neck tornado test.
See this image and copyright information in PMC

References

    1. Bono CM, Ghiselli G, Gilbert TJ. et al. An evidence-based clinical guideline for the diagnosis and treatment of cervical radiculopathy from degenerative disorders. Spine J. 2011;11:64–72. - PubMed
    1. Cohen I, Jouve C. Cervical radiculopathy. In: Frontera WR, Silver JK, Rizzo TD, editors. Essentials of physical medicine and rehabilitation: musculoskeletal disorders, pain, and rehabilitation, 2nd ed. Philadelphia, Pa: Saunders/Elsevier; 2008. pp. 17–22.
    1. Radhakrishnan K, Litchy WJ, O'Fallon WM. et al. Epidemiology of cervical radiculopathy. A population-based study from Rochester, Minnesota, 1976 through 1990. Brain. 1994;117(Pt 2):325–35. - PubMed
    1. De Luigi AJ, Fitzpatrick KF. Physical examination in radiculopathy. Phys Med Rehabil Clin N Am. 2011;22:7–40. - PubMed
    1. Shah KC, Rajshekhar V. Reliability of diagnosis of soft cervical disc prolapse using Spurling's test. Br J Neurosurg. 2004;18:480–3. - PubMed