Ruptured Cervical Intervertebral Disks

Abstract

Lateral rupture of the cervical intervertebral disks should be considered in the differential diagnosis in a patient with a history of pain or stiffness of the neck, with radiation of pain to the shoulder, arm or hand. In some cases the superficial impression may be that of angina pectoris. Differential diagnosis between cervical rib and scalenus anticus syndrome and cervical disk can usually be made on the basis of the point of reference of pain or numbness. In cases of cervical disk rupture, symptoms and signs are usually referable to the sixth and seventh cervical dermatomes, whereas the other conditions usually involve the eighth dermatome. Roentgenograms of the cervical spine frequently show reversal of the normal curve and narrowing of the suspected interspace.

Cervical disks which rupture closer to the midline may produce signs and symptoms of degenerative cord disease, such as amyotrophic lateral sclerosis, or may even cause complete paralysis simulating spinal cord tumor.

Because of the great risk of cord compression, manipulative treatment is hazardous. Conservative therapy, using halter traction and a Thomas collar, is advisable before proceeding with myelography and surgery. The results of surgery are excellent.