Spine Cervical Spine Evidence: uncertain

Vertebral Artery Test (VBI) Special Test

Orthopedic Physical Examination & Clinical Assessment Guide

Vertebral Artery Test (VBI) Orthopedic Special Test

What is it used for?

  • Screening for Vertebrobasilar Insufficiency (VBI) before performing cervical manipulation.

How to Perform

  • Position: Patient supine with head off the table.
  • Action: Examiner passively extends the neck, laterally bends, and rotates the head to the same side. Hold for 30 seconds.
  • Observation: Patient keeps eyes open. Talk to them to check speech.

Interpretation of Results

  • Positive Test: Dizziness, nystagmus (eye flickering), slurred speech (dysarthria), or nausea (The '5 Ds').
  • Why: This position compresses the vertebral artery on the contralateral side. If the ipsilateral artery is blocked/stenotic, blood flow to the brainstem drops.

Diagnostic Accuracy

  • Sensitivity: 0-57% (Low)
  • Specificity: 67-100%

References

  • Magee, D. J. (2021). Orthopedic Physical Assessment.