Cervical disc herniation
Overview
Cervical disc herniation is a clinical condition wherein the intervertebral disc between the two vertebral bodies in the neck can herniate back, pressing on the spinal cord or the nerves that connect the arms and hand.
Symptoms
Most people (almost 90%) may have disc herniation, yet they would not have any complaints. The remaining 10% may present symptoms like:
i. Neck pain
ii. Shooting pain along the arm up to hand, together with decreased sensation or weakness of the hand.
iii. In rare cases, multiple disc herniations or a single large disc herniation can compress the spinal cord, causing symptoms in both upper limbs and lower limbs. [Cervical myelopathy].
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Diagnosis
Physical examination by a doctor has a key role in the diagnosis and decision-making on management of this condition. As more than 90% are asymptomatic, unnecessary investigations can cause panic and a sense of nervousness in the patients.
After a clinical diagnosis is made, your doctor may advise an X-ray or MRI of cervical spine to confirm the diagnosis and aid in deciding the treatment.
Treatment
Almost 80% of symptomatic disc herniation patients can get better with conservative management, in the form of medications, posture care, neck exercises and physiotherapy.
Only few patients who don’t get good relief with conservative treatment may need surgery in the form of either Anterior Cervical Discectomy and Fusion (ACDF) or Anterior Cervical Disc Replacement (ACDR). The surgery is performed on the front of the neck where a small cut is made and the affected disc removed, thereby relieving pressure on the nerve root and spinal cord. Stabilizing is done either by fusion with bone graft (ACDF) or artificial disc replacement (ACDR).
