J Korean Soc Spine Surg.  2002 Mar;9(1):48-53. 10.4184/jkss.2002.9.1.48.

Clinical Symptoms of Internal Disc Disruption of the Cervical Spine

• Kang CH
• Jeon SH
• Lee H

• KMID: 1897090
• DOI: http://doi.org/10.4184/jkss.2002.9.1.48

Abstract

STUDY DESIGN: This study reviewed 20 patients who were diagnosed as internal disc disruption (IDD) of the cervical spine. Clinical symptoms were analyzed retrospectively.
OBJECTIVES
To assess the various symptoms of IDD of the cervical spine. Summary of Literature Review : Several studies have demonstrated the symptoms of lumbar spine IDD. No studies have attempted to show the symptoms of cervical spine IDD.
MATERIALS AND METHODS
A group of patients, who showed chronic neck pain and referred pain to upper limbs after a certain trauma, was materials of this study. All these patients were examined with simple X-ray, flexion-extension views, magnetic resonance image (MRI). When intractable pain was prolonged over 6months in spite of conservative treatment, patient was admitted and performed discogram and computed tomograpy (CT) for a definite diagnosis. There were 20 patients who were diagnosed as IDD from July 1996 to June 2001, and clinical symptoms were analyzed retrospectively.
RESULTS
The various symptoms of the IDD of the cervical spine were chronic neck pain (100%), shoulder pain (95%), headache (90%), interscapular pain (80%), arm pain and paresthesia (75%), insomnia (75%), hand pain and paresthesia (60%), periocular pain (60%), forearm pain and paresthesia (50%), chin pain (50%), subjective weakness of upper extremity (45%), periauricular pain (40%) and tinnitus (30%).
CONCLUSION
We are led to believe that patients who have chronic neck pain, shoulder pain, interscapluar pain, and other symptoms after a certain trauma of cervical spine are clinically diagnosed as IDD of the cervical spine, although X-ray and MRI are normal. Definite diagnosis of these patients would be made by a discogram, if similar or identical pain is provocated.

Keyword

Cervical spine; Internal disc disruption; Clinical symptoms

MeSH Terms

Arm
Chin
Diagnosis
Forearm
Hand
Headache
Humans
Magnetic Resonance Imaging
Neck Pain
Pain, Intractable
Pain, Referred
Paresthesia
Retrospective Studies
Shoulder Pain
Sleep Initiation and Maintenance Disorders
Spine*
Tinnitus
Upper Extremity

Figure

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  Fig. 1. Anteroposterior and lateral roentgenograms of patient without cervical spine fracture and dislocation.

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  Fig. 2. Lateral flexion-extension roentogenograms of patient without cervical spine instability.

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  Fig. 3. The MRI of the cervical spine shows normal findings without herniated disc and spinal cord compression. A. T2 weighted sagittal MRI. B. T2 weighted axial MRI at C4-5. C. T2 weighted axial MRI at C5-6.

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  Fig. 4. Appearance of the discogram at C5-6 is leakage.

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  Fig. 5. The CT discograms at C4-5 and C5-6 reveal circumferential tear and dye leakage.

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  Fig. 6. Anteroposterior and lateral roentgenograms of C4-5 and C5-6 fusion with autogenous bone graft.

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