Stability Test: Sharp Purser Test

Standing to the side of the patient, one hand is on the patient's forehead and the "key grip" hand position of the thumb and index finger of the other hand is at the spinous process of C2 to stabilize. Clinician flexes the patient's head on neck and applies a posteriorly-directed force through the forehead contact against the stabilized C2 vertebra. Test is positive if reduction of C1 on C2 is noted, the end feel is soft, or patient reports symptoms including esophageal pressure and other neurologically related cord compression symptoms.