Cervical Disc Herniation
Discs are circular cartilaginous tissue that help to cushion the spaces between our vertebrae. Inside of each disc is a gelatinous material that does much of the cushioning work. There are six cervical discs in the human body. They’re all located in the neck. While they prevent vertebrae from rubbing on each other, they also provide elevation to accommodate spinal nerves that pass on both sides of the cervical vertebrae.
Common Causes of Cervical Disc Herniations
A disc becomes herniated when it ruptures. The gelatinous substance inside of the disc gets pushed out, and that puts pressure on the spinal cord or the root of a spinal nerve. The pressure can cause neck, shoulder and arm pain, muscle spasms, numbness and weakness in an arm or hand. Some common causes of cervical disc herniations include motor vehicle crashes, falls, work injuries and diving accidents.
Diagnosing Cervical Disc Herniations
A herniated disc consists of soft tissue, so it’s not going to show up on an x-ray. It might be inferred if the bones on the image are are too close together though. If x-rays have not already been taken, a doctor will start with a physical exam for purposes of testing a patient’s reflexes, muscle strength, sensitivity to touch, pinpricks or vibration. After that, one or more of the following tests might be ordered:
- A CT scan that takes x-rays from many directions and gives cross-sectional views of the spine and the structures around it.
- Magnetic resonance imaging (MRI) that can pinpoint where a herniated disc is, and what spinal nerves are affected.
- A CT scan and myelogram when dye is injected into a patient’s spinal fluid. X-rays are then taken, that can show any pressure on the spinal cord or spinal nerves.
Expect a doctor to start treatment conservatively with over-the-counter medications. If those don’t provide relief, you’re likely to move up to prescription medication or even cortisone injections. If the pain and discomfort still hasn’t subsided, physical therapy will likely be recommended. Please note that only your doctor can decide your best treatment based on your unique injury.
Cervical spine disc herniation surgery is said to be 95 to 98 percent effective for purposes of relieving arm pain. Here are three approaches:
- In an anterior cervical discectomy and fusion, a one inch incision is made in the front of the neck, and the herniated disc and debris is removed. The disc space is then fused. A plate can be added for purposes of even more stability from the fusion.
- A posterior discectomy is performed from the back of the neck, but it’s more difficult and carries higher risks because of blood vessels and bleeding. The posterior approach also involves moving the spinal cord. Blood can interfere with seeing the spinal cord.
- Cervical disc replacement again involves an incision at the front of the neck, but after the natural disc is removed, an artificial disc is placed in the space.
A person’s age, overall health and the type of procedure performed are all variables in the recovery equation. Patients are likely to be referred to physical therapy after a discectomy and fusion. The fastest path to reaching maximum medical improvement is a commitment to actively participating in scheduled physical therapy sessions rather than ignoring them.