Herniated Discs at the Cervicothoracic Junction

Abstract

Disc herniations at the cervicothoracic junction (C7-T1 level) are unusual, and there have only been a few studies of patients with herniated C7-T1 discs. In addition, previous studies did not focus on the mechanism and causes of solitary cervicothoracic junction disc herniation. The authors investigated the characteristics, symptom duration, clinical course, and biomechanics of cervicothoracic junction disc herniation by comparing patients with C7-T1 disc herniation (C7-T1 group) with control groups. Thirty-six patients who underwent solitary C7-T1 single-level disc surgery between 2006 and 2015 were included. For radiographic comparison, patients in a herniated C5-C6 disc group and the healthy control group were cohort matched. In the C7-T1 group, the disc herniation mainly occurred in the foraminal space (P < 0.0001). The C7-T1 group was significantly associated with a history of trauma (P < 0.0001). In addition, the cervical vertebral body was more readily observed on plain lateral radiographs in the C7-T1 group (7.36 ± 0.068). Patients in the C5-C6 group tended to have the sternal notch more frequently located above the T2-T3 disc space than other groups (P= 0.014). C7-T1 disc herniation demonstrates unique characteristics. Understanding the features of disc herniation at the cervicothoracic junction would be helpful for optimal care.