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Cervical Disc Herniation

Cervical Disc Herniation

Herniation of a disc is a condition characterized by leakage of the inner contents of the intervertebral disc, due to cracks in its outer wall. If this occurs in the neck, it may be associated with neck pain or arm symptoms that may arise due to compression of the spinal nerves by the protruding disc material (cervical radiculopathy). This condition is frequently reported in people between 30-40 years of age as well as elderly people. Treatment of cervical radiculopathy begins with conservative (non-surgical) methods, as reports show that around 90% of patients may return to normal activity by employing these interventions for at least 6 weeks. The patients who do not experience benefit from conservative interventions are recommended for surgery.

The cervical region consists of 7 cervical vertebrae (C1-C7), with intervertebral discs between each vertebra that function to provide flexibility to the backbone. Intervertebral discs are soft, compressible structures consisting of a hard-outer ring called the annulus and a gel-like center, called the nucleus.

Causes and Symptoms

The foremost causes and risk factors involved in the development of cervical herniated disc are advanced age, trauma or injury, abrupt neck movements, smoking and genetic factors. The usual symptoms associated with cervical herniated disc are pain and numbness in the neck, shoulders, chest, arms, and hands, followed by weakness in the associated region. It should be understood that most herniated discs cause no symptoms at all.

Diagnosis

The diagnosis of a cervical herniated disc involves studying the medical history and performing a physical examination of the patient. Physical examination may also involve analysis of the neck movements to determine the source of pain and related injured tissues. Other tests that can help diagnose radiculopathy include X-rays, MRI scan, myelogram, CT, electromyography (EMG) and nerve conduction velocity (NCV) tests.

Treatment

The well-established non-surgical interventions for cervical radiculopathy include adequate rest, ice or heat compression, physical therapy, strengthening exercises and medications, including epidural steroid injections. In addition, widely accepted holistic therapies such as acupuncture, acupressure, and nutritional supplements are also extensively used.

Surgery is recommended for those patients who are not responding to non-surgical measures and for those with worsening neurologic deficits. Discectomy can be performed through minimally invasive techniques that employ a small incision for the operation. These advanced techniques have short recovery time and high success rate.

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