The normal intervertebral disc is composed of a nucleus pulposus, at the center, surrounded by a fibrous ring known as annulus fibrosis. Cervical disc herniation is a condition in which the inner gelatinous substance of the disc escapes through a tear in the outer, fibrous ring causing a compression of the spinal cord or the surrounding nerves, resulting in neck or arm pain. Herniated disc is also known as a bulging disc, ruptured disc or slipped disc.
Causes
A cervical herniated disc may be caused by wear and tear of the disc due to the normal aging process or an injury to the cervical spine.
Symptoms
The predominant symptom of a cervical disc herniation is pain. The pain can range from mild to severe and is usually aggravated by movement. Other symptoms include problems with gait and balance, numbness, tingling and weakness radiating down your shoulder, arm, and hand, and rarely bladder and bowel problems.
Diagnosis
Your doctor will usually diagnose a herniated disc from your history of symptoms and a physical examination. Your doctor may also perform a neurological examination to evaluate your sensations, reflexes, and the strength of the muscles. Other imaging tests such as X-rays, MRI or CT scan may be ordered to confirm the diagnosis of a herniated disc. X-rays of the cervical spine may be taken to locate the collapsed disc space. A CT and MRI scan provides better visualization of the anatomy of the intervertebral discs and spinal cord.
Treatment
Treatment comprises of conservative and surgical treatment options. The conservative treatment options such as anti-inflammatory and pain medications, muscle relaxants, physical therapy, spinal injections, certain types of braces, and acupuncture can help reduce pain and associated symptoms. To increase the success of the treatment, your doctor may combine two or more treatment modalities.
Some people with cervical herniated disc may require surgery. Surgery is indicated for patients with unstable spine or neurological dysfunction and patients with persistent pain which does not improve with non-surgical treatment. Anterior cervical discectomy is a common surgical procedure for the management of cervical disc herniation. Anterior cervical discectomy and fusion (ACDF) is a type of minimally invasive surgical procedure performed through the front of the neck to remove a herniated disc from the cervical spine region. Sometimes, spinal stabilization and fusion may be required to reduce the pain and stabilize the spine.
Your surgeon will discuss surgical options and recommend the appropriate treatment plan for you.
