A positive result on the Spurling neck compression test is most indicative of which condition?

• A. Cervical radiculopathy
• B. Thoracic outlet syndrome
• C. Cervical myelopathy
• D. Brachial plexus neuritis

Answer: (A)

Spurling neck compression test checks whether a cervical nerve root is irritated or compressed. By extending the neck, tilting the head toward the affected side, and applying downward pressure, if sharp, shooting pain or numbness radiates down the arm in a dermatomal pattern, that indicates the nerve root is being irritated. This makes cervical radiculopathy the best fit, as it specifically reflects nerve root compression from things like disc herniation or foraminal stenosis.

Thoracic outlet syndrome involves compression in the thoracic outlet and can cause arm symptoms, but those are not typically reproduced by this neck-focused compression maneuver. Cervical myelopathy affects the spinal cord and presents with signs such as gait disturbance, hyperreflexia, and more widespread neurological involvement rather than a single radicular pattern. Brachial plexus neuritis causes shoulder and arm pain and weakness from inflammatory plexus involvement, not a focal nerve root compression detected by this test. So the positive result most strongly points to cervical radiculopathy.