Hubungan Tes Spurling dengan derajat Penyempitan Foramen Neuralis Berdasarkan Pemeriksaan MRI Servikal pada Pasien Radikulopati Servikal

Muhammad Diastika Bakhtiar, dr. Subagya,Sp.N.,Subsp.NGD(K).; dr. Indra Sari Kusuma Harahap,Ph.D.,Sp.N.,Subsp.ENK(K)

2026 | Tesis-Spesialis | S2 Ilmu Penyakit Saraf

Latar Belakang: Tes Spurling mendukung penilaian klinis radikulopati servikal, sedangkan MRI menilai penyempitan foramen neuralis secara struktural. Hubungan antar keduanya masih belum jelas.

Tujuan: Mengetahui hubungan hasil tes Spurling dengan derajat penyempitan foramen neuralis pada MRI servikal potongan aksial pada pasien radikulopati servikal.

Metode: Penelitian potong lintang melibatkan pasien berusia 18–65 tahun dengan nyeri leher menjalar ke tangan di RSUP Dr. Sardjito Yogyakarta pada Agustus– Oktober 2025. Dilakukan pemeriksaan Spurling, Valsalva, distraction, upper limb tension, dan shoulder abduction. MRI aksial dinilai menggunakan metode Seo et al. (2023) dan dikategorikan normal–ringan atau sedang–berat. Analisis menggunakan chi-square atau Fisher exact, dilanjutkan regresi logistik multivariat pada variabel p<0>

Hasil: Sebanyak 43 subjek dianalisis; rerata usia 46,0±11,4 tahun dan 38 (88,4%) perempuan. Tes Spurling positif pada 35 (81,4%). MRI aksial menunjukkan penyempitan normal–ringan pada 29 (67,5%) dan sedang–berat pada 14 (32,5%). Tes Spurling positif menunjukkan probabilitas lebih tinggi terhadap penyempitan sedang–berat, tetapi tidak bermakna (OR=4,14; IK95% 0,46–37,50; p=0,240). Analisis multivariat juga tidak menunjukkan hubungan bermakna (OR=7,08; IK95% 0,60–83,32; p=0,120).

Kesimpulan: Tidak terdapat hubungan bermakna antara hasil tes Spurling dan derajat penyempitan foramen neuralis pada MRI servikal potongan aksial. Temuan klinis dan radiologis perlu diinterpretasikan bersama.

Background: Spurling test supports clinical assessment of cervical radiculopathy, whereas cervical magnetic resonance imaging (MRI) evaluates structural neural foraminal narrowing. Their relationship remains uncertain.

Objective: To determine the association between Spurling test results and the degree of neural foraminal narrowing on axial cervical MRI in patients with cervical radiculopathy.

Method: This cross-sectional study included consecutive patients aged 18–65 years with neck pain radiating to the arm at Dr. Sardjito General Hospital, Yogyakarta, during August–October 2025. Spurling, Valsalva, distraction, upper limb tension, and shoulder abduction tests were performed. Axial cervical MRI was graded using the method of Seo et al. (2023) and categorized as normal-mild or moderate-severe. Chi-square or Fisher exact tests were followed by multivariable logistic regression for variables with p<0>

Results: Forty-three subjects were analyzed; mean age was 46.0±11.4 years old and 38 (88.4%) were women. Spurling test was positive in 35 (81.4%). Axial MRI showed normal–mild Narrowing in 29 (67.5%) and moderate–severe narrowing in 14 (32.5%). A positive Spurling test showed higher odds of moderate–severe narrowing, but the association was not significant (OR=4.14; 95%CI 0.46–37.50; p=0.240). Multivariable analysis also showed no significant association (OR=7.08; 95%CI 0.60–83.32; p=0.120).

Conclusion: No significant association was found between Spurling test results and the degree of neural foraminal narrowing on axial cervical MRI. Clinical and radiological findings should be interpreted together.

Kata Kunci : radikulopati servikal, tes Spurling, penyempitan foramen neuralis, MRI servikal