Upper limb neurodynamic testing with radial and ulnar nerve biases: an analysis of cervical spinal nerve mechanics

Review written by Dr Carlo Wood info

Key Points

  1. Significant displacement occurs parallel to spinal nerves (greatest at C7). Perpendicular displacement was only significant at C7 during radial nerve bias, and C6 and C7 during ulnar nerve bias.
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BACKGROUND & OBJECTIVE

The literature states neurodynamic tests (NDTs) can be used in combination to produce high sensitivity and low specificity for the diagnosis of cervical radiculopathy. The median nerve shows the highest sensitivity and the radial nerve the lowest. The ulnar nerve shows a high specificity when “positive”, indicating radiculopathy. To exclude a radiculopathy when “negative”, the other tests may be used.

The median nerve test produces significant amounts of tension in both the nerve, cords and spinal nerves C5–C8. The purpose of this study was to determine whether the radial and ulnar nerve tests elicit displacement/strain of spinal nerves.

Neurodynamic tests can be used in combination to produce high sensitivity and low specificity for the diagnosis of cervical radiculopathy.
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It may assist the clinical reasoning process to utilize the radial nerve bias to seek out impairment in C6, and ulnar nerve bias for C8.

METHODS

Nine unembalmed cadavers were used for the study. Spherical metal markers were placed in the vertebral bodies of C6-8, and tubercles of the intervertebral foramen to verify cervical spine position during testing. Two metal markers were implanted within each spinal

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