Significance of Symptoms and Signs in Localization of Involved Root in Cervical Disk Protrusion

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Abstract
The symptoms and signs found in 100 patients with confirmed protrusions of single cervical disks treated and relieved by operation have been analyzed. In 2 cases root C-5 was involved, in 19 root C-6, in 69 root C-7, and in 10 root C-8. Of all the findings reviewed, sensory symptoms or objective changes in the digits and localized muscle weakness were found to be the most reliable signs and symptoms for localization of the lesion to one root. Decreased activity in one or more of the major stretch reflexes of the upper extremity and localized pain in the forearm are highly significant in localizing the lesion to one of 2 roots. The authors'' study has revealed that an accurate history and reliable neurologic examination made it possible in 87 of 100 cases to predict correctly whether root C-5, C-6, C-7, or C-8 was compressed. If, in addition, lumbar puncture is carried out but does not show evidence of block or a markedly elevated value for total protein, it should be possible for the neurosurgeon to approach the compressed root directly and confidently without the aid of a preoperative myelogram, and, as a rule, to find that the cause of the root compression is a laterally protruded cervical disk.

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