Neck Orthopaedic Test: Bakody Sign

The Bakody Sign test is a diagnostic test used to assess radicular pain, particularly at the C4-C6 nerve roots and to potentially alleviate symptoms by temporarily reducing pressure on the nerves. The test is named after Dr. Sigurd Bakody, a neurologist who first described the technique in the early 1940s.

Here is a step-by-step procedure for performing the Bakody Sign test:

1. Explain the procedure to the patient and obtain their consent for the test.
2. Have the patient sit or stand in a comfortable position with their back straight.
3. Instruct the patient to raise the affected arm on the side of the radicular pain and place the hand on top of their head.
4. Instruct the patient to hold this position for at least 30 seconds.
5. Observe the patient for any relief of symptoms such as a decrease in pain, numbness, tingling, or weakness in the affected arm.
6. Repeat the test on the unaffected side for comparison.
7. If the patient experiences any symptoms, stop the test immediately.
8. Record the results of the test in the patient's medical chart.

The test is considered positive if the patient experiences a decrease in pain, numbness, tingling, or weakness in the affected arm when it is raised and placed on top of their head. A negative result occurs when the patient experiences no change in symptoms.

References:

1. Bakody S. The Bakody sign. Neurology. 1945 Mar; 3(3): 221-2. doi: 10.1212/WNL.3.3.221.
2. Halpern AA, Halpern BC. Cervical radiculopathy: the role of conservative care. Complement Ther Clin Pract. 2009 Nov;15(4):172-81. doi: 10.1016/j.ctcp.2009.05.001. Epub 2009 Jun 11. PMID: 19880014.
3. Gervasio O, Gambardella G, Zaccone C, Branca D. Cervical radiculopathy: treatment and results in 24 cases. Acta Neurochir Suppl. 2005;92:57-60. doi: 10.1007/3-211-27577-0_11. PMID: 15830972.
4. Sekiguchi M, Kikuchi S, Myers RR. Experimental spinal stenosis: relationship between degree of cauda equina compression, neuropathology, and pain. Spine (Phila Pa 1976). 2004 Aug 15;29(16):E370-7. doi: 10.1097/01.brs.0000134639.30424.18. PMID: 15284503.