Bakody Sign

Introduction

This test was designed to assess radicular pain, specially at the C4-C6 nerve roots. It is otherwise known as the shoulder abduction test. This test can be suggestive of cervical nerve involvement, but however isn't diagnostic of it.

History

Dr John Bakody, a neurosurgeon developed this technique, in1977 and published the same in the Surgical Neurology.

Purpose

It is used to diagnose cervical radiculopathy, it is as definitive as the spurlings test however is less painful. It can also be used in case of a herniated disc pathology, spinal nerve root compression, acute neck pain which could be neural related.

Procedure

The subject could be sitting or lying down. The limb has to be actively or passively raised above the head with the palm of the hand above the head.

Interpretation

Positive sign: Reduction in symptoms with the painful arm placed on top of the head. The suggested mechanism includes reduction of pain as the traction force to the nerves and the lower brachial plexus trunks are relieved. with the arm hanging at the side of ones body the mechanical traction acting n the nerve increases , thus increasing symptoms.

Negative sign: Increase in the symptoms when the patients hand is placed on the head. These symptoms are probably increased due to inter scalene muscle compression. Thus placing the hand could be termed positive for inter scalene compression and negative for Bakody sign.