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February 4, 1974

Soft Cervical Disk Herniation

Author Affiliations

Englewood, Colo

JAMA. 1974;227(5):560. doi:10.1001/jama.1974.03230180058032

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To the Editor.—  I enjoyed reading the article by Drs. Lourie, Shende, and Stewart in the Oct 15 issue (226:302, 1973).I recall the case of a 70-year-old man whose main symptoms were incoordination and loss of balance, particularly when he rode in an airplane. But the symptoms also were worse when riding on any transportation device that might cause vibration. It turned out that the patient did have the syndrome described by Lourie et al, but all of his symptoms went away following a conservative treatment by cervical neck traction.In regard to technique, I prefer a combination of the Smith-Robinson and Cloward techniques, as described by Wiltberger (Am J Surg 105:670, 1973). A bone plug is inserted anteriorly but does not reach the posterior longitudinal ligament. Most of the disk can be removed with pituitary forceps.