Herniated Cervical Discs
Caused by normal wear and tear of the spine, herniated discs can often be managed without surgery.
Your cervical spine is made up of seven vertebrae. The discs between your vertebrae allow your neck to be flexible. They are made up of two types of cartilage, an inner and an outer part. The outer part of your discs is comprised of tough layers of cartilage. The inner part of your discs is made up of cartilage that is more “jelly-like.” This inner cartilage acts as a shock absorber.
What causes a herniated disc?
If the outer cartilage develops a tear, the inner “jelly-like” cartilage can then squeeze out of the disc. If this disc material pushes on your nerves, you can experience severe pain down your arm. This is often called radiculopathy. The tears are typically caused by degeneration of the discs (wear and tear). Patients will often describe the onset of their symptoms after lifting something and/or bending or twisting the neck.
Signs and symptoms
In addition to pain, pressure on nerves from a disc herniation can also cause numbness, tingling, burning, and weakness in your arm. Extremely large herniations can compress your spinal cord leading to balance difficulties, problems using your hands, and even paralysis of your arms and legs. This is called myelopathy and can be considered a medical emergency. If you experience bowel or bladder problems and have progressively worsening weakness in your arms or legs, you should seek medical attention immediately.
The diagnosis is first suspected when a patient complains of pain radiating from their neck down their arm. Patients will also commonly complain of numbness, tingling, and burning down their arm. They may also have muscle weakness. After a detailed examination, the diagnosis can be initially evaluated with plain X-rays and confirmed with an MRI or CT scan of the cervical spine.
Luckily, most disc herniations do not require surgery because your body can naturally absorb the herniated disc. Therefore, many patients can initially be treated with pain management, physical therapy, and activity modification.
Patients with more severe or persistent symptoms may benefit from an epidural spinal injection. Patients with very severe pain and those who do not achieve long-lasting pain relief from injections may be candidates for surgery.
One of the most common surgical procedures we use to remove the herniated disc is called a minimally invasive decompression (laminoforaminotomy) and is performed through a half-inch incision through the back of the neck. Patients are able to go home the same day as the procedure.
The other time-tested surgical approaches involve going through the front of the neck and include either fusing the vertebrae or replacing the disc with an artificial prosthesis. Your surgeon can go over the advantages and disadvantages of each of these surgical options with you.