title: The Actual Level of Symptomatic Soft Disc Herniation in Patients with Cervical Disc Herniation.
abstract: OBJECTIVE
  The aim of this study was to predict the relationship between the symptomatic disc herniation level and the osteophyte level or decreased disc height in patients with cervical disc herniation.
  
  
  METHODS
  Between January 2011 and December 2012, 69 patients with an osteophyte of the cervical spine underwent surgery at a single center due to soft cervical disc herniation. Data including soft disc herniation level, osteophyte level in the posterior vertebral margin, Cobb's angle, and symptom duration were retrospectively assessed. The patients were divided into three groups according to the relationship between the degenerative change level and the level of reported symptoms.
  
  
  RESULTS
  Among the 69 patients, 48 (69.6%) showed a match between osteophyte level and soft disc herniation level. Disc herniation occurred at the adjacent segment to degenerative osteophyte level in 12 patients (17.4%) and at both the adjacent and the osteophyte level in nine (13.0%). There was no significant difference in Cobb's angle or duration among the three groups. Osteophyte type was not significant. The mean disc height of the prominent degenerative change level group was lower than the adjacent segment level, but this was not significant.
  
  
  CONCLUSIONS
  Soft cervical disc herniation usually occurs at the level an osteophyte forms. However, it may also occur at segments adjacent to that of the osteophyte level. Therefore, in patients with cervical disc herniation, although a prominent osteophyte alone may appear on plain radiography, we must suspect the presence of soft disc herniation at other levels.
authors.affiliation: Department of Neurosurgery, Gachon University Gil Medical Center, Incheon, Korea.
authors.forename: Su Yong
authors.initials: SY
authors.lastname: Choi
authors.affiliation: Department of Neurosurgery, Gachon University Gil Medical Center, Incheon, Korea.
authors.forename: Sang Gu
authors.initials: SG
authors.lastname: Lee
authors.affiliation: Department of Neurosurgery, Gachon University Gil Medical Center, Incheon, Korea.
authors.forename: Woo Kyung
authors.initials: WK
authors.lastname: Kim
authors.affiliation: Department of Neurosurgery, Gachon University Gil Medical Center, Incheon, Korea.
authors.forename: Seong
authors.initials: S
authors.lastname: Son
authors.affiliation: Department of Neurosurgery, Gachon University Gil Medical Center, Incheon, Korea.
authors.forename: Tae Seok
authors.initials: TS
authors.lastname: Jeong
keywords: Intervertebral disc; Intervertebral disc degeneration; Osteophyte; Spinal fusion