Provocative Tests in Cervical Spine Examination

[문형철]

해부학적 구조와 생체역학적 움직임을 이해하면 이러한 검사법에 대한 신뢰도, 타당도에 대한 연구는 

그리 중요치 않다. 

골프채를 주고 골프를 치는 방법을 알려줬다.

어떤 사람은 싱글을 치고, 어떤 사람은 백돌이다. 

백돌이의 신뢰도, 타당도는 많이 떨어진다. 

같은 방법을 사용한 프로골퍼는 신뢰도, 타당도가 높다. 

그런 차이다.  

panic bird....

Provocative Tests in Cervical Spine Examination.pdf

Abstract

The majority of the provocative tests described for physical examination of the neck and cervical spine relate to identification of radiculopathy, spinal cord, or brachial plexus pathology. These tests are often performed routinely by many providers with variable methods and interpreted in a variety of ways. Several commonly performed provocative tests include Spurling's Neck Compression Test, Shoulder Abduction (Relief) Test, Neck Distraction Test, L'hermitte's Sign, Hoffmann's Sign and Adson's Test. 

This review describes some specialized provocative tests with comprehensive literature review. The goal of this review is to develop standardization in the performance and clinical use of these tests. Each of the tests described in this manuscript apparently originated from the anecdotal observations of experienced, well respected clinicians. However, only few studies have been performed addressing the interexaminer reliability or validity of these tests. 

The existing literature appears to indicate high specificity, low sensitivity, and good to fair interexaminer reliability for Spurling's Neck Compression Test, the Neck Distraction Test, and The Shoulder Abduction (Relief) Test when performed as described. For Hoffman's Sign, the existing literature does not address interexaminer reliability but appears to indicate fair sensitivity and fair to good specificity. For L'hermitte's Sign and Adson's Test, not even tentative statements can be made with regard to interexaminer reliability, sensitivity, and specificity, based on the existing literature. It is concluded that more research is indicated to understand the clinical utility of all the provocative tests employed in the physical examination of the neck and cervical spine.