Bakody Sign

Original Editor- Ashmita Patrao Top Contributors - Ashmita Patrao, Kim Jackson and Chelsea Mclene

Introduction[edit | edit source]

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[1] nerve involvement, but however isn't diagnostic of it.[2]

History[edit | edit source]

Dr John Bakody, a neurosurgeon developed this technique in 1977 and published the same in the Surgical Neurology[3].

Purpose[edit | edit source]

It is used to diagnose cervical radiculopathy and is as definitive as the spurling's 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[edit | edit source]

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

Interpretation[edit | edit source]

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 one's body the mechanical traction acting on 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.[4][5]

References[edit | edit source]

  1. Schliesser JS, Kruse R, Fallon LF. Cervical radiculopathy treated with chiropractic flexion distraction manipulation: a retrospective study in a private practice setting. Journal of manipulative and physiological therapeutics. 2003 Nov 1;26(9):592-6.
  2. Davis FA. Bakody sign [Internet]. Tabers online, Unbound medicine. Available from: https://www.tabers.com/tabersonline/view/Tabers-Dictionary/773522/all/Bakody_sign
  3. Johnson I. Bakody sign. Surgical Neurology. 1977 Jun 1;7(6):370-.
  4. Jorgensen E. Bakody’s Sign: Cervical Radiculopathy Orthopaedic Test [Internet] . Obtained from: https://healthcog.com/bakody-sign-position/
  5. Magee, David J. Orthopedic Physical Assessment. St. Louis, Mo: Saunders Elsevier, 2008.
  6. Physiotutors. Shoulder Abduction Sign | Cervical Nerve Root Pathology. Available from https://www.youtube.com/watch?v=8_AHkiiPYS8
  7. The student physical therapist. Bakody's sign. Available from https://www.youtube.com/watch?v=UIex5_XoU04