Cervical Flexion Compression Test

What is The Cervical Flexion Compression Test?

The cervical flexion compression test is used to identify if there is a herniated disk in the cervical spine. Or if there is anything that is causing cervical nerve root compression that could be going down in the arms.

The cervical flexion compression test is an excellent way to determine the integrity of the intervertebral disk. The intervertebral disk is present between each vertebra. The intervertebral discs allow the vertebral columns to be flexible. And it also acts as a shock absorber in everyday activities such as running, walking, and jumping.

What does Cervical Flexion Compression Test Do?

The cervical flexion compression test indicates the presence of postero-lateral intervertebral disk extrusion. A disk extrusion is a type of severe disk herniation. It occurs when the center or nucleus of the intervertebral disk escapes from the center of the disk. An extruded disk can occur in the neck, mid or lower back. This extrusion (herniation) causes cervical nerve root compression (cervical radiculopathy)

The cervical flexion compression test will press the extruded portion of the disk in the posterior direction, which results in the increased compression of the cervical nerve root.

This test involves compression so it also reduces the space in the cervical intervertebral foramina. An intervertebral foramina is an opening present between each pair of spinal vertebrae. Several structures pass through the foramina, like the root of each spinal nerve, spinal artery, and veins. And this reduction of space in the cervical intervertebral foramina causes irritation of the cervical nerve root.

intervertebral-foramina

Therefore, the cervical flexion compression test produces two effects that increase compression in the cervical nerve root.

1 – By pressing the extruded portion of the disk in the posterior direction.

2 – By reducing the space in the cervical intervertebral foramina which causes irritation of the cervical nerve root.

Therefore increase in radicular symptoms can therefore signal the presence of posterior lateral disk extrusion (disk herniation).

The forward tilting of the head usually reduces the load on facet joints. Therefore, forward tilting of the head can reduce localized pain in the cervical spine, which is due to degenerative changes. Hence, if there is a reduction in the localized pain in the cervical spine, this will indicate irritation of the facet joint which is due to degenerative changes in the cervical spine.

Therefore, increasing localized pain in the cervical spine may indicate an injury to the posterior ligamentous structures.

How To Perform The Cervical Flexion Compression Test?

Position of the Patient  The patient should be in a seated position

Position of the Examiner – The examiner stands behind the patient.

  • After that, the examiner passively moves the cervical spine into flexion (tilts the patient’s head forward).
  • Once the patient is in that position, the examiner uses one or both hands and very gently applies mild axial compression (downward force) on the top of the patient’s head.

Cervical-extension-compression-test

Test Results 

Well, the test results of the cervical flexion compression test depend upon the symptoms produced during the test.

Therefore increase in radicular symptoms can therefore signal the presence of posterior lateral disk extrusion (disk herniation).

The forward tilting of the head usually reduces the load on facet joints. Therefore, forward tilting of the head can reduce localized pain in the cervical spine, which is due to degenerative changes. Hence, if there is a reduction in the localized pain in the cervical spine, this will indicate irritation in the facet joints which is due to degenerative changes in the cervical spine.

Therefore, increasing localized pain in the cervical spine may indicate an injury to the posterior ligamentous structures.

And in case if there are no radicular symptoms or localized pain or reduction in the localized pain in the cervical spine, this will indicate a negative cervical flexion compression test.

You May Also Read –

Nerve Root Disorder Test

Thomsen Sign – Indicates or signals sciatic nerve root irritation.

Duchenne Sign – Assess a nerve root disorder.

Some Other Test

Cervical Extension Compression Test – To Detect the Presence of Posterolateral Disk Extrusion (Disk herniation) with an intact annulus fibrosus

Jackson Compression Test –  To Detect Cervical Radiculopathy (Cervical Nerve Root Compression).

Spurling Test – For Diagnosing Cervical Radiculopathy

Cervical Distraction Test – To detect the presence of cervical radiculopathy.

O’Donoghue Test – Helps in differentiating between muscular pain (strain) and ligamentous pain (articular problem) in the cervical spine.

Soto Hall Test – For Detecting Problem in Patient’s Neck (Cervical Spine)

Maximum Compression of the Intervertebral Foramina Test of Cervical Spine – For Detecting Facet Joint Dysfunction in the Cervical Spine

Resources

Clinical Tests for the Musculoskeletal System: Examinations-Signs-Phenomena by K. Buckup

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