Protrusion of the first thoracic disk.

A case of lateral prolapse of the T-1/T-2 intervertebral disk is presented. The patient complained of pain radiating down the medial aspect of the forearm into the little and ring fingers. This was associated with a subjective sensory loss in the same distribution, intact reflexes, and no long tract signs. Oculosympathetic paralysis was not present. Twelve cases have been mentioned in the literature, only eight of which contain details of the neurological findings. The varied findings in these cases are also reviewed, and it is noted that unless radiological examination includes the upper thoracic spine in cases of brachial neuralgia, these lesions will be missed.