The "neck test" can refer to a few different clinical assessments involving the neck. The most likely intended meaning is the Neck Distraction Test, a physical examination maneuver used to assess for cervical radiculopathy. Another possible interpretation could be Lhermitte's sign, which also involves neck movement.
Here's a breakdown of each test:
1. Neck Distraction Test (Spurling's Test Reverse)
The Neck Distraction Test is performed to relieve pressure on cervical nerve roots and assess if this alleviates radicular symptoms (pain, numbness, tingling radiating down the arm).
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Procedure: The examiner gently grasps the patient's head under the occiput (back of the skull) and chin, then applies a slow, steady, upward (distractive) force, lifting the head slightly to relieve pressure on the cervical spine. The patient should be seated.
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Positive Result: A positive test occurs when the distraction maneuver reduces or eliminates the patient's cervical radicular symptoms. This suggests that pressure on a nerve root in the neck is contributing to the symptoms.
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What it Indicates: A positive Neck Distraction Test suggests cervical radiculopathy, possibly caused by disc herniation, spinal stenosis, or other conditions that compress nerve roots in the cervical spine.
2. Lhermitte's Sign (or Lhermitte's Phenomenon)
Lhermitte's sign is not technically a "test" performed by an examiner, but rather a symptom reported by the patient in response to neck flexion.
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Procedure: The examiner passively flexes the patient's cervical spine forward, bringing the chin toward the chest.
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Positive Result: A positive test involves the patient reporting a sudden, brief, electric shock-like sensation that travels down the spine, often radiating into the arms or legs, during neck flexion.
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What it Indicates: Lhermitte's sign indicates a possible lesion or dysfunction of the spinal cord, often associated with multiple sclerosis, cervical spondylosis with myelopathy, transverse myelitis, or other conditions that irritate or damage the spinal cord's dorsal columns.
Therefore, the "neck test" can refer to either the Neck Distraction Test (for cervical radiculopathy) or the assessment for Lhermitte's sign (for spinal cord dysfunction), depending on the clinical context.
