Cervical Disc Herniation
What is cervical disc herniation?
Cervical disc herniation is a painful rupture of the outer cartilage of a cervical disc. Cervical discs are the cushions between the vertebrae in the upper back and neck. If they become damaged by degeneration or injury, they may bulge abnormally or break open. Common terms for this condition include herniated disc, slipped disc or ruptured disc.
How does cervical disc herniation occur?
Cervical disc herniation is usually caused by wear and tear or injury. As we age, our discs gradually lose the fluid that helps them maintain flexibility. Discs become stiffer and shorter, causing the vertebrae to move closer together. A herniated disc also may result from injuries to the spine, which can cause tiny tears or cracks in the disc’s outer layer. The jellylike material inside is forced out, which causes the disc to bulge, break open or break into fragments.
What are the symptoms?
Symptoms of cervical disc herniation may include:
- Neck pain
- Pain that radiates down the arm to the hand or fingers
- Numbness or tingling in the shoulder, arm or hands
- Weakness of the arm or hand
- Burning pain in the shoulders, neck or arm
In some patients, cervical disc herniation can cause spinal cord compression, which is a potentially life-threatening condition that requires immediate medical attention. Symptoms include:
- Awkward or stumbling gait
- Difficulty with fine motor skills in the hands and arms
- Tingling or shock-type feelings down the torso or into the legs
If you are experiencing any of these symptoms, seek medical help immediately.
How is cervical disc herniation diagnosed?
In addition to a complete physical exam and patient history, your doctor can use specific tests, including X-ray, MRI and CT scan,to diagnose a herniated disc. Sometimes, a test called an electromyogram is used to check electrical activity along the nerves and pinpoint the area of damage.
What is the treatment?
Many patients will improve with non-surgical treatment. This may include rest, a neck brace, non-steroidal anti-inflammatory medication, corticosteroids, epidural injections or physical therapy.
If these conservative treatments don’t work, surgery may be necessary. The goal of surgery is to remove the portion of the disc that is pushing on the nerve, maintain spine stability and correct spine alignment.
There are several appropriate and successful surgical options, including:
- Anterior cervical discectomy and fusion. The surgeon makes an incision in the front of the neck to reach the spine. The problem disc is removed, along with any bone spurs, and the vertebrae are fused together with a bone graft. Sometimes screws or a titanium plate are used to increase stability between the vertebrae.
- Posterior cervical laminoforaminotomy. The surgeon makes an incision in the back of the neck to reach the spine. The bone compressing the nerve root is removed, along with the problem disc. Fusion is not necessary.
- Cervical disc replacement. This procedure is an exciting advancement in spine surgery and, for carefully selected patients, a good alternative to the traditional fusion technique. The surgeon removes the diseased disc and, rather than using a bone graft to fuse, replaces it with a prosthetic disc. The device preserves motion and eliminates the typical complications of fusion surgery.
Both posterior cervical laminoforaminotomy and cervical disc replacement avoid spinal fusion and may result in a faster recovery. However, as with all surgical procedures, specific recovery time varies by patient and demand.
The type of procedure performed depends on the location of the herniated disc, as well as a patient’s age, overall health and other factors. Not everyone is a candidate for disc replacement surgery. A surgeon who is trained in both spine fusion techniques and disc replacement technology is the best person to determine the most appropriate surgical option for the patient. A consultation with the proper surgeon is crucial in making that determination.