Unique features of herniated discs at the cervicothoracic junction: clinical presentation, imaging, operative management, and outcome after anterior decompressive operation in 10 patients

Neurosurgery
Nicholas H PostMary Ellen Costa

Abstract

Disc herniations at the C7-T1 level are unusual (4% of all herniated cervical discs) and are often incorrectly diagnosed because of unusual neurological findings and suboptimal imaging studies. Furthermore, the anterior approach may be problematic because the manubrium and slope of the vertebral bodies away from the surgeon obscures the end plates. The recurrent laryngeal nerve and the thoracic duct may be injured by respective right- or left-sided approaches. A posterior approach to this level has, therefore, been advocated, but results of C7-T1 herniations treated anteriorly have not been specifically addressed in the literature. We, therefore, reviewed our experience in the operative management of patients undergoing single level anterior cervical discectomy and fusion at the C7-T1 interspace for the 10 years ending June 2004 with regard to clinical presentation, imaging, problems of operative exposure, and neurological outcome. Of 268 patients with single level anterior cervical discectomy and fusions (ACDFs), 10 (3.7%) had C7-T1 disc herniations. We retrospectively reviewed the medical records, operative reports, and imaging studies of these 10 patients. All patients presented with C8 motor deficit without myelopathy. The ...Continue Reading

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Citations

Dec 17, 2008·HSS Journal : the Musculoskeletal Journal of Hospital for Special Surgery·Jeffrey RadeckiZachary R Zimmer
Sep 1, 2009·Case Reports in Medicine·Toshimi AizawaEiji Itoi
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Jun 19, 2020·Journal of Craniovertebral Junction and Spine·Keyvan MostofiBabak Gharaei Moghadam

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