A Cervical Disc Herniation is a problem of the disc that lies between the bones of the spine. This disc is made of a soft cartilage material and can rupture and push back against the spinal nerves or the spinal cord. This can result in symptoms in the neck and along the nerves that are being compressed.
A cervical disc herniation often will lead to symptoms of pain, numbness, or weakness in the arm along the area of the nerve root that is being compressed. Patients may or may not have symptoms of neck pain or soreness or headaches, but most of the symptoms can be located in the arm. In severe cases, the disc can compress the spinal cord and lead to loss of balance, loss of coordination, and severe neural dysfunction.
The radiographic evaluation of a suspected spine disorder begins with a plain x-ray. A herniated disc, being composed of soft tissue rather than bone, will not be seen on x-ray; however, other associated changes may be seen, such as the arthritic changes, disc space narrowing, and bone spurs. An MRI scan is the best way to diagnose this condition and can show the nerves, the disc, and the bones. When bony detail is required, a myelogram/CT should be obtained. It is more invasive than MRI and may produce effects such as headache, but in some cases may be essential in defining the anatomy.
Conservative treatment is typically the first type of treatment and can include rest, non-steroidal medications, a short course of oral steroids, and physical therapy. If symptoms do not resolve, an epidural may be indicated, which is an injection of steroids into the area of nerve compression. When there is progressive neurological problems or the symptoms are not alleviated with the conservative care, surgical treatment can provide excellent results. Surgery can consist of a minimally invasive foraminotomy, an anterior discectomy and fusion, or a disc arthroplasty (disc replacement) to try to preserve movement.