Journal of back and musculoskeletal rehabilitation
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J Back Musculoskelet Rehabil · Jan 1995
Types of cervical disc herniation and relation to myelopathy and radiculopathy.
Cervical disc herniation is divided into three types with respect to the intraspinal location of the herniated mass: median, paramedian and lateral herniations. Median herniation presses the spinal cord against the lamina and deforms it into a boomerang shape in a cross section, thereby giving rise to myelopathy of the central cord syndrome or transverse lesion syndrome, according to Crandall's classification. Paramedian herniation presses the spinal cord unilaterally and deforms it into a comma shape. ⋯ Of our 202 patients with myelopathy, 36% had median herniation and 64% had paramedian herniation. Of our 24 patients with radiculopathy, 12% had paramedian herniation and 88% had lateral herniation. Other matters pertinent to the management of patients are described.
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Rapid, thorough and cost effective radiologic evaluation of the traumatized spine can be performed through a tailored sequential approach. The radiologic evaluation is performed in conjunction with clinical management, and therefore communication between clinical and radiological services is essential. Judicious use of CT and MRI can provide critical information, particularly in the symptomatic patient with 'normal' radiographs.