| Definitions: Cervical Herniated Disc |
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Definition Herniated disc means displacement of the nucleus from its normal postion within the boundaries of its outer fibrous ring (the annulus). The disc structure is composed of the soft centered nucleus and the outer fibrous ring (the annulus). The disc structure is postioned in between the vertebra. Herniations commonly occur posteriorly(towards the back of the body) due to a thinner boundary. The spinal nerves and dura (fluid filled sack containing spinal cord and cervical spinal nerves at this level of the spine) are located behind the disc structure. Diagnosis The diagnosis is made from the history, physical exam performed by the doctor and diagnostic imaging studies (MRI, myelogram, CAT scan with contrast). If the herniation puts pressure on a cervical spinal nerve, then the patient may complain of pain, weakness or numbness in the arm. If the herniation puts pressure on the spinal cord and a cervical nerve, then in addition, the patient may have numbness in both hands, clumsy hands, difficulty walking, electric shocks through the body with movement of the neck, bowel and bladder symptoms or paralysis. Non-Surgery Treatment Most cervical disc herniations put pressure on a single cervical nerve and those patients can be treated with non-operative measures: restriction of activity, cervcial collar, traction, medications, epidural steroid injections. A cervical disc herniation that produces symptoms from the spinal cord is usually operated on. Surgical Treatment The surgical indications for cervical disc herniation is indicated for nerve root symptoms: weakness, numbness and pain in an arm or due to the spinal cord symtpoms: numbness in both hands, clumsy hands, difficulty walking, electric shocks through the body with movement of the neck, bowel and bladder symptoms or paralysis Prognosis Many patients with cervical disc herniations effecting a cervical spinal nerve improve without surgery. In those patients undergoing surgery for nerve decompression, the surgical results are generally good. Patient with a cervical disc herniation producing pressure and symptoms from the spinal cord, the surgical results depend on many different factors. |