Sunday, 08th Apr 2018

Though uncommon, when present it is accompanied with neurological manifestations in the upper extremities, rarely the signs of spinal cord compression may be present.

The disc ruputre may occur as a result of intrinsic changes in the disc substance or as a result of an injury. A part of gelatinous nucleus pulposus extrudes through a rent in the annulus fibrousus at the weakest part of the cervical spine. The C5-C6 or C6-C7 intervertebral levels are the common sites of the disc protrusion.

The protrusion may be:

  • Mild: Causing compression of the posterior longitudinal ligaments and localised pain.
  • Moderate: When it herinates through the posterior ligament and presses laterally on the emerging nerve root, causing lateral prolapse of the disc.
  • Severe: Central protrusion compresses over the spinal cord.

The symptoms may be present in the neck and/or upper limb.

A clinical and neurological examination with emphasis on the movements of neck, arm muscle bulk, sensory status and reflexes will provide information regarding the extent, site and nature of the pathology.


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