Cervical Disc Herniation

Understanding Cervical Disc Herniation

Cervical disc herniations are a prevalent medical condition often resulting in neck and arm pain due to the compression of nerves in the neck. This condition can cause numbness, tingling, weakness, or loss of coordination in both upper and lower limbs, contingent on the compressed structures.

The Spinal Structure

The spine is composed of 33 vertebrae bones, with the first 7 making up the cervical spine. The vertebrae are separated by intervertebral discs made of cartilage, which act as shock absorbers and facilitate the spine’s movement. The discs have a softer central component, the nucleus, and a firmer outer layer, the annulus. The spinal cord travels from the brain’s base to the spine’s base through the spinal canal, located centrally in the vertebral column behind the discs. A pair of spinal nerves exits the spinal canal through the intervertebral foramen at each level.

Causes of Compression

Compression of a spinal nerve or the spinal cord can occur due to various reasons, including degeneration, herniated or ruptured disc, trauma, tumors, or bone spurs. Such compressions are common post 30 years of age as discs lose their elasticity, potentially causing neck pain and some arm pain.

Healing and Treatment

Remarkably, about 90% of disc protrusions heal with the resorption of the disc from 2 weeks to 3 months. However, in 10% of cases, the herniated disc material causes severe pain and compression of the nerves, necessitating surgical intervention for severe nerve or spinal cord compression.

Surgical Approaches

Anterior Approach:

Surgery through the front of the neck is less invasive, minimizing trauma to the muscle as structures anterior to the spine are easily movable. The downside is that to access the spinal cord and nerves, the complete disc has to be removed, requiring the cavity to be filled with a fusion device or an artificial disc.

Posterior Approach:

A posterior approach can also be minimally invasive but necessitates some cervical musculature to be reflected away from the bone to access the spinal column. The advantage here is that the majority of the normal disc is left intact, removing only the herniated disc material.

Postoperative Care

Both types of surgeries typically last around 1.5 hours, with a usual hospital stay of 1-2 days. Generally, patients can return to all normal activities post cervical disc surgery.

Understanding cervical disc herniation is crucial for individuals experiencing neck and arm pain due to nerve compression in the neck. Most cases heal naturally, but severe conditions require surgical interventions, which, thanks to advanced medical practices, are now less invasive with quicker recovery times.

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