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FIG 5. Postdiskogram CT images in the 48-year-old man with chronic neck and right arm pain where difficulty was encountered in access to the C4–5 disk space despite attempted displacement of the larynx with the prong deflector tool. The hyoid bone is wide and the anterior aspect of the C4 vertebral body (black arrow) projects deeply into the gap between the hyoid cornua (arrowheads), preventing displacement of the hyoid and thyroid cartilages across the midline. Without hyoid and thyroid cartilage displacement, clear and safe access to the disk space could not be obtained.
