Cervical Disc Herniation
Cervical Disc Herniation
The cervical spine (neck) is the upper portion of the spinal column. Seven segments comprise the cervical spine. A cervical disc is the gel-like spacer separating the cervical vertebrae. As the cervical disc degenerates (ages), a tear of the outer rim (annulus) can occur and a herniation of the inner part of the disc can migrate posteriorly (backwards) and cause compression of the spinal cord or cervical nerve. Cervical disc herniation can occur because of traumatize events such as an accident, lifting, sports, or cumulative neck strain.
Symptoms can include severe neck pain and arm pain which can radiate down the arm and into the hand. Numbness and tingling into the hands and fingers, loss of grip, strength, and arm strength can occur. If spinal cord compression results from a cervical disc herniation, weakness of both arms or legs can occur along with loss of balance, coordination, and impaired fine motor skills (writing, finger dexterity).
MRI imaging confirms the cervical disc herniation in most cases. Many patients improve with restriction of activities such as avoiding overhead reaching, pulling or lifting heavy items. Arm and neck pain can be relieved with anti-inflammatory medications, steroids, physical therapy, or spinal nerve block.
Surgery may be necessary if pain or neurologic deficit remains severe despite conservative measures. Surgery involves removal of the intervertebral disc and extruded herniation causing spinal cord or nerve root compression from an anterior approach (front to the neck). Replacement of the disc with an artificial disc replacement or anterior fusion is commonly performed. 90% of the patients can return to normal function and resume activity within 8 weeks from surgery.
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