What is a Cervical Disc Herniation?

Cervical discs are the six soft capsules or cartilaginous shock absorbers that lie between the bony vertebrae of the neck. These discs help to cushion the vertebrae and absorb shock caused by movement of the spine. They also make the neck more flexible. Occasionally, the outer layer of a disc in the neck may become damaged. When this occurs, the inner jelly-like material can leak out of the disc, putting pressure on the spinal nerves. This is called a cervical disc herniation.

Causes

Discs normally have a high fluid content. With age, however, the discs can lose some of this fluid. This causes them to become less flexible and increases the risk of small tears that can lead to herniation. Age can also cause discs to lose some of their height. This can interfere with the nerves as they leave the spinal cord, leading to neck pain and other symptoms. A related issue is when a disc does not actually tear but the inner disc material bulges outward. This can cause symptoms similar to a disc herniation.

Cervical disc herniation becomes more common with age and is frequently experienced by people who smoke cigarettes. Cervical disc herniation can also result from neck trauma due to a sports injury or other incident. People with poor posture and who do not exercise regularly may also be at higher risk for a herniated cervical disc.

Symptoms

Herniated cervical discs frequently cause pain in the neck, shoulders, and arms. They may also cause weakness, tingling, or numbness in the arms or hands, usually on one side of the body. The pain may become heightened after sitting or standing for long periods or when coughing or sneezing. Less common is when the herniated disc impinges on the spinal cord. This can lead to weakness in the legs, a loss of balance, and bowel or bladder problems (referred to as “myelopathy”). If these symptoms develop, seek medical attention as soon as possible.

Diagnosis

A personal health history and thorough clinical exam are important factors in making a herniated cervical disc diagnosis. The exam usually includes X-rays and imaging studies such as MRIs. A CT scan and myelogram study may also be needed in cases where the diagnosis is in question.

Treatment

The majority of cervical disc herniations improve with rest, anti-inflammatory medications, and physical therapy. Some people also benefit from epidural steroid injections into the spine to reduce inflammation and nerve irritation.

Surgery becomes an option when more conservative measures are unsuccessful. The most common surgery performed for a herniated cervical disc is an anterior cervical discectomy, during which the surgeon enters the spine from the front and removes all or a portion of the affected disc. If the entire disc is removed, a bone graft and a metal plate may be inserted as a replacement. Most people experience some pain immediately following the surgery, but the pain usually subsides quickly during recovery. Other options include posterior surgery to decompress the nerve root or artificial disc replacement surgery.