Morgan H, Abood C
Department of Neurological Surgery, University of Texas Southwestern Medical Center at Dallas, 75235-8855, USA.
J Neurosurg. 1998 Jan;88(1):148-50. doi: 10.3171/jns.1998.88.1.0148.
In preparing this paper, the authors reviewed their experiences with four cases of T1-2 disc herniation as well as the medical literature on the subject. Intervertebral thoracic disc herniations are uncommon and high thoracic disc herniations are rare. In the upper third of the thoracic spine, T1-2 is the most common level for disc ruptures. Four cases of disc herniation at T1-2 that caused T-1 radiculopathy are reported in this paper. In reviewing the literature on thoracic disc herniation, the authors found 27 cases at the T1-2 level, 23 of which were lateral disc herniations that produced radiculopathy and four of which were central disc herniations that caused myelopathy. The clinical signs and symptoms of T-1 radiculopathy are similar to those of C-8 radiculopathy; however, distinguishing features can frequently be found on neurological examination. The T-1 radiculopathy usually involves weakness of the intrinsic muscles of the hand. The motor deficit of C-8 radiculopathy involves the intrinsic muscles of the hand and most of the flexors and extensors of the fingers and wrist. The T-1 radiculopathy may produce Horner's syndrome (oculosympathetic paralysis) and diminished sensation in the axilla, which are not found with C-8 radiculopathy. In clinical presentation as well as in treatment, the lateral T1-2 disc herniation resembles a cervical disc herniation, whereas the central T1-2 disc herniation displays the usual appearance of a thoracic disc herniation.
在撰写本文时，作者回顾了他们处理4例T1-2椎间盘突出症的经验以及关于该主题的医学文献。胸椎椎间盘突出症并不常见，而高位胸椎椎间盘突出症则更为罕见。在胸椎上三分之一区域，T1-2是椎间盘破裂最常见的节段。本文报告了4例T1-2椎间盘突出症导致T-1神经根病的病例。在回顾胸椎椎间盘突出症的文献时，作者发现T1-2节段有27例病例，其中23例为外侧椎间盘突出症导致神经根病，4例为中央椎间盘突出症导致脊髓病。T-1神经根病的临床体征和症状与C-8神经根病相似；然而，在神经检查中经常可以发现其鉴别特征。T-1神经根病通常累及手部的固有肌。C-8神经根病的运动功能障碍累及手部的固有肌以及手指和手腕的大部分屈肌和伸肌。T-1神经根病可能会产生霍纳综合征（眼交感神经麻痹）和腋窝感觉减退，而C-8神经根病则不会出现这些症状。在临床表现和治疗方面，T1-2外侧椎间盘突出症类似于颈椎间盘突出症，而T1-2中央椎间盘突出症则表现出胸椎椎间盘突出症的常见症状。
