CERVICAL DISK LESIONS

Abstract

Among 175 cases of unilateral ruptured soft disk, the lesion in 122 cases was found at the sixth cervical interspace. Among 46 cases of foraminal spur with nerve root compression, the lesion in 22 cases was found at this same level. This was the most frequent location for either lesion. Compression of the sixth or seventh cervical nerve roots impaired the function of the muscles of the arm, but the muscular effects of lesions at these two levels did not differ enough to afford a basis for distinguishing between them. Hypalgesia observed in 173 patients affected the thumb most frequently (43 cases) when the lesion was at the sixth cervical nerve root and the second finger most frequently (100 cases) when the lesion was at the seventh cervical nerve root. This did not afford a reliable basis for preoperative diagnosis of the level of the lesion, because with involvement of either nerve root hypalgesia was often found in more than one finger. The value of roentgenographic and myelographic methods of localizing the lesion was likewise found to be limited. Criteria for evaluating the results of surgical treatment were applied in a followup study of 175 patients who were operated on for unilateral disks; the results were excellent in 94. The results of operations for foraminal spur, medial disk protrusion, and cervical spondylosis were observed in smaller series and varied considerably from those in unilateral ruptured disk.