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Sports Medicine

Ventral cord indentation vs. compression

08/08/2005

Question:

After a recent football injury, I got the following medical report: "At C3-4, there is a small central disc herniation causing minimal indentation of the ventral cervical cord but no posterior cord compression. Neural foramina and central canal dimensions are normal at this level." While I have had strange symptoms since the accident(pain in shoulders, arms and legs plus numbness and tingling in feet and hands, fingers and toes) the doctor I saw didn`t think the above was serious because there was no "cord compression." He recommended physical therapy and maybe a nerve block injection. What`s the real clinical difference between cord "indentation" and "compression?" They both sound pretty ominous to me. Any idea of the success rate of PT for a condition like this vs. surgery?

Answer:

The good news here is that your neural foramina and canal dimensions are normal.  You have a mild disc herniation of the C3-C4 discs with minimal indentation of the spinal cord.  This level of herniation is usually not significant enough to cause prolonged problems.  Compression results when the herniation is severe enough that it is really pushing on the cord and usually causes severe and prolonged symptoms.  I think the physical therapy option is the best first approach.  I would avoid surgery at this point given the mild state of the herniation.

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Response by:

Charles Webster, MD
Assistant Professor
College of Medicine
University of Cincinnati