When a cervical disc prolapses, central protrusion presents with signs of spinal cord compression.
A postero-lateral protrusion presents with acute neck stiffness within hours or days following the insult. It is aggravated by coughing and other straining. Later, there is pain radiating over the shoulder and throughout the upper limb. There may be paraesthesia in the digits.
On examination, certain neck movements may be limited by pain but movement in at least one direction, often lateral flexion, is free. There may be slight muscle wasting and sensory impairment in the distribution of the cervical nerves with the corresponding tendon reflexes depressed or absent.
The clinical picture is variable. A history of injury may not always be obtainable; symptoms may be confined to either the neck or to the upper limb; muscle wasting may be marked or absent.
There may be further attacks, either sudden or gradual in onset.
More details concerning cervical disc prolapse in context of cervical spondylosis is provided in the linked item below.
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