Maximum Cervical Compression Test: Checking Nerve Roots & Facets

The Maximum Cervical Compression Test is an orthopedic maneuver that places the cervical spine in a position of maximal closure for the intervertebral foramina and facet joints. It is used to distinguish between radiculopathy and facet dysfunction.

[Image of Maximum Cervical Compression Test]

1. Purpose

The primary purpose of the Maximum Cervical Compression Test is to **verify** the presence of intervertebral foramen (IVF) encroachment, which can cause nerve root compression (radiculopathy). It can also assess for facet joint dysfunction.

2. How to Perform

1. The patient is seated.
2. The patient actively extends their head, laterally flexes (side bends) to the affected side, and rotates their head to the same side.
3. This position places the cervical spine in the "close-packed" position, maximally narrowing the foramen and compressing the facets on that side.
4. The examiner applies a downward compressive force to the top of the head.

3. Positive & Negative Sign

Positive Sign (Test is POSITIVE):
A positive test is indicated by the reproduction of pain:

• Radiating pain into the arm: Indicates nerve root compression (Radiculopathy).
• Localized neck pain: Indicates facet joint pathology.

Negative Sign (Test is NEGATIVE):
A negative test is when there is no reproduction of symptoms or pain.