Neck Hernia (Cervical Disc Hernia)
What Is A Cervical Disc Hernia and How Does It Occur?
The spine consists of bones called ‘vertebrae‘, which are arranged on top of each other. In the middle of each vertebral body is the spinal cord, which is the continuation of the brain. The senses that return to the brain from various parts of the body or the orders that are dispersed from the brain to the body run inside the spinal cord. The nerves that emerge from the level of each vertebral body in the neck area also spread to the arm and back, providing the sensation and movement of these areas.
These bones, called vertebrae, are connected to each other by flexible structures called ‘discs’, which have elastic properties. Over time, these flexible structures, that is, discs, fray out and lose their elasticity.
As such, this disc is protruding backwards with traumas or loads. In other words, this disease occurs as a result of the internal part of the discs in the consistency of gelatin tearing the outer part consisting of a stronger connective tissue and pressing on the spinal cord and nerves.
This hernia in the neck causes pain, which we call ‘radicular pain’ that spreads from the shoulder to our fingers. Neck movements, especially the backward movement of the head, can increase pain.
What Are The Symptoms of Cervical Hernia?
The most common cause of complaint is pain. Pain can be described in different ways, such as blunt, sharp, electric shock or knife stab. In the affected dermatome area, paresthesia or loss of sensation may occur.
Neck movements are usually limited. Pain, which is the main symptom, may spread to an area starting from the cervical region and extending to the occiput, nape muscles, shoulders and upper extremities.
Various symptoms such as temporary or irreversible feeling of stiffness caused by pain, numbness in the upper extremities, numbness, tingling, weakness, dizziness with neck movements due to affecting the vertebral arteries or sympathetic nerves, headache and imbalance can be seen.
What Are The Treatment Methods In Cervical Disc Hernia?
The main goal in the treatment is to reduce the pain sensation of the patients and to allow them to continue their daily life activities without pain. Pain sensation that occurs for various reasons is the first reason for patients to apply to the clinic.
In patients admitted to the clinic with the diagnosis of cervical disc pathology, early mobilization, reducing the overload on the joints, ensuring the protection of injured tissues and exercises are the most basic treatment elements in order to control pain, oedema and inflammatory condition in the acute period.
With the application of ice on the affected area, non-steroidalanti-inflammatory drugs are useful in suppressing oedema and inflammation. For the acute period; basic treatment techniques used in cervical disc pathologies; it is useful to give administering nonsteroidal anti-inflammatory drugs as well as to put ice to the affected area. With the decrease in inflammation, hot applications can be started to relieve soft tissues later.
Along with medical treatment, physical therapy methods are usually sufficient to reduce pain. If there is short-term bed rest, auxiliary device use, and soft tissue tension, stretching and relaxation exercises can be given together with joint range of motion exercises.
Chronic period; In cervical disc pathologies, the time required to reduce pain may be longer than in the acute period. The main goal is to provide normal joint range of motion, increase the strength, endurance and coordination of the cervical region and the surrounding muscles, accelerate the return to normal daily life activities and prevent new injuries by leaving a permanent result of treatment.
Surgical treatment may be necessary for patients whose pain does not go away with medical treatment methods, who have significant loss of strength, and who have significant spinal cord compression. The aim of surgery is to eliminate the part of the disc that presses on the spinal cord and nerve. This is done by a method called discectomy.
Depending on the location of the disc hernia, the surgeon performs the surgery through the incision opened in front and behind the neck to reach the spine. In both approaches, the pressure of the disc material on the nerve structures is eliminated. The results are usually good.
In the anterior approach, bone material and motion-protective prostheses can be placed instead of disc material, which is usually discharged between the vertebrae, to provide fusion.