What is Cervical Disc Herniation and How Does It Occur?

The spine consists of bones, which we call 'vertebra', arranged on top of each other. In the middle of each vertebral body is the spinal cord, which is a continuation of the brain. Sensations returning to the brain from various parts of the body or orders distributed from the brain to the body travel within the spinal cord. Nerves originating from the level of each vertebral body in the neck region spread to the arms and back, providing sensation and movement to these areas. These bones, called vertebrae, are connected to each other by flexible structures that we call 'discs'.

Over time, these flexible structures, namely the discs, wear out and lose their elastic properties. As such, this disc protrudes backwards due to trauma or loads. In other words, cervical herniation occurs as a result of the gelatin-like inner part of the discs tearing the outer part, which consists of a stronger connective tissue, and putting pressure on the spinal cord and nerves. This herniation in the neck causes pain that we call 'radicular pain', which spreads from the shoulder to the arm and down to our fingers. Neck movements, especially movement of the head backwards, can increase the pain.

What are the symptoms of cervical disc herniation?

The most common cause of complaint is pain. Pain can be described in various ways, such as dull, sharp, electric shock or stabbing. Paresthesia or loss of sensation may occur in the affected dermatome area. Neck movements are generally limited.

Pain, which is the main symptom, may spread in an area starting from the cervical region and extending to the occiput, neck muscles, shoulders and upper extremities. Various symptoms may occur, such as a temporary or irreversible feeling of stiffness due to pain, numbness in the upper extremities, numbness, tingling, weakness, dizziness that increases with neck movements due to the effect of the vertebral arteries or sympathetic nerves, headache, and imbalance.

What are the Treatment Methods for Cervical Disc Herniation?

The main goal of treatment is to reduce the pain sensation of patients and allow them to continue their daily life activities without pain. Pain, which occurs due to various reasons, is the first reason why patients apply to the clinic. In the acute period in patients who apply to the clinic with the diagnosis of cervical disc pathology; In order to control pain, edema and inflammatory conditions, early mobilization, reducing excessive load on the joints, protection of injured tissues and exercises are the most basic treatment elements.

Applying non-steroidal anti-inflammatory drugs along with applying ice to the affected area is useful to suppress edema and inflammation. Acute period; Basic treatment techniques used in cervical disc pathologies; In addition to applying ice to the affected area, it is useful to give nonsteroidal anti-inflammatory drugs. Once the inflammation subsides, hot applications can then be started to relax the soft tissues. Physical therapy methods combined with medical treatment are usually sufficient to reduce pain. Short-term bed rest, use of assistive devices, and if soft tissue tension is present, stretching and relaxation exercises can be given along with joint range of motion exercises. Chronic period; In cervical disc pathologies, the time required to reduce pain may be longer compared to the acute period. The main purpose is to ensure normal joint range of motion, to increase the strength, endurance and coordination of the cervical region and surrounding muscles, to accelerate the return to normal daily life activities and to prevent new injuries by leaving a permanent result of the treatment.

Surgical Treatment Surgical treatment may be necessary for patients whose pain is not relieved by medical treatment methods, who have significant loss of strength, and who have significant spinal cord compression. The aim of surgery is to remove the part of the disc that puts pressure on the spinal cord and nerve. This is done by a method called discectomy. Depending on the location of the disc herniation, the surgeon performs the surgery through incisions made in the front and back of the neck to reach the spine. In both approaches, the pressure of the disc material on the nerve structures is eliminated.

The results are generally good. In the anterior approach, instead of the disc material that is usually emptied between the vertebrae, bone material and movement-protecting prostheses can be placed to provide fusion.