A cervical hernia occurs when a disc in the neck region of the spine ruptures, causing pain and difficulty moving the upper body. Symptoms vary based on which disc is affected, and treatment options include nonsurgical conservative treatment and surgical treatment.
A cervical hernia occurs when a disc in the cervical, or neck, region of the spine swells or ruptures. Other terms used for a herniated disc are “herniated nucleus pulposus” (HNP), “slipped disc” and “ruptured disc”. The disc is a fibrous cushion with an outer band called the annulus fibrosis that surrounds a gelatinous substance called the nucleus pulposus. The discs are located between each of the seven vertebrae in the neck and are intended to cushion the movements of the spine. When a disc herniates, the outer band of the disc protrudes, tears or ruptures, allowing the gel-like substance to leak out.
Like other vertebrae, the cervical vertebrae have holes, or holes, through which the spinal cord passes. Unlike the rest of the spine, however, the vertebrae of the spine also have a small foramen for a major artery, the cervical nerves, which control the arms, neck, and upper torso. If a disc ruptures in this region of the spine, it can put pressure on the cervical nerve roots called cervical radiculopathy, causing pain and difficulty moving the upper body. On rare occasions, the rupture puts pressure on the spinal cord, called cervical myelopathy, which is a more serious medical problem.
A cervical hernia usually occurs in the lower part of the neck. Cervical discs are smaller and less prone to rupture than discs in the lumbar spine. However, chronic poor posture or neck strains can weaken the disc over time and culminate in a herniated disc. Disc degeneration associated with normal aging contributes to the problem, as the nucleus pulposus leaks fluid. Acute trauma can also cause a cervical hernia, particularly in cases where the patient has suffered a whiplash. Whiplash occurs when the neck is suddenly and forcefully thrust in one or more directions, as often happens in traffic accidents.
The symptoms of a cervical hernia vary based on which disc is affected. The most common symptoms include a pain that radiates from the neck to the arm, pins and needles or pins and needles (paraesthesia) in the arm, or weakness of the arm muscles. A patient with cervical myelopathy, in which the spinal cord is compressed, may experience spasticity, a neurological condition in which muscles are constantly being commanded to contract and relax. This can present with loss of bowel control or difficulty walking. Patients with these symptoms should receive immediate medical attention to prevent permanent neurological damage.
The vertebrae of the spine are numbered with the lowest at the top of the spine (closest to the head) and given a letter to describe its region. Thus, C1 describes the vertebra in the cervical region closest to the head, C7 describes the vertebra in the cervical region furthest from the head, and T1 describes the vertebra in the thoracic spine (the rib region) closest to the head. If the disc between C4 and C5 is ruptured, the patient can expect numbness or weakness in the shoulder, the disc between C5 and C6 can cause forearm numbness and numbness in the upper arm and thumb, the disc between C6 and C7 can cause numbness in the middle finger and all pads and weakness in the wrist, and the disc between C7 and T1 may show weakness in the hand grip and numbness in the ring and little fingers.
After diagnosing cervical hernia, a doctor will decide between nonsurgical conservative treatment and surgical treatment. Most patients with ruptured discs do not require surgery. Nonsurgical movement usually involves limiting movement of the cervical spine and keeping the neck flexed forward to reduce pressure on the nerve roots. The patient is also commonly given anti-inflammatory pain medications and may choose to undergo cervical traction, in which the spine is pulled in opposite directions to reposition the vertebrae. This should only be conducted by a specialist doctor.
In severe cases, a doctor will perform surgery to fix the ruptured disc. This commonly takes the form of an anterior discectomy and fusion (ACDF), in which the doctor operates from the front. The surgeon will remove a piece of the disc and replace it with another bone from the patient or a donor. Posterior discectomies are less common and more complex, requiring the removal of a piece of bone to access the disc that needs to be removed.
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