DISC HERNIATION AT T1-2 - REPORT OF 4 CASES AND LITERATURE-REVIEW

In preparing this paper, the authors reviewed their experiences with f our cases of T1-2 disc herniation as well as the medical literature on the subject. Intervertebral thoracic disc herniations are uncommon an d high thoracic disc herniations are rare. In the upper third of the t horacic spine. T1-2 is the most common level for disc ruptures. Four c ases of disc herniation at T1-2 that caused T-1 radiculopathy are repo rted in this paper. In reviewing the literature on thoracic disc herni ation, the authors found 27 cases at the T1-2 level. 23 of which were lateral disc herniations that produced radiculopathy and four of which were central disc herniations that caused myelopathy. The clinical si gns and symptoms of T-1 radiculopathy are similar to those of C-8 radi culopathy: however, distinguishing features can frequently be found on neurological examination. The T-1 radiculopathy usually involves weak ness of the intrinsic muscles of the hand, The motor deficit of C-8 ra diculopathy involves the intrinsic muscles of the hand and most of the flexors and extensors of the fingers and wrist. The T-l radiculopathy may produce Homer's syndrome (oculosympathetic paralysis, and diminis hed sensation in the axilla, which are not found with C-8 radiculopath y. In clinical presentation as well as in treatment, the lateral T1-2 disc herniation resembles a cervical disc herniation, whereas the cent ral T1-2 disc herniation displays the usual appearance of a thoracic d isc herniation.