Neck pain and symptoms caused by a herniated disc are quite common in adults. The cushion type tissue between the bones in your neck are called intervertebral discs. These discs are composed of a soft gel-like center and a tough outer lining and create a joint between the bones in the spine that allows them to move. A herniated disc occurs when the lining surrounding the disc tears and the soft center is pushed through the opening.
A herniated disc may be caused by numerous things. The most common of which is the simple process of aging. As we get older, the discs din our spines can lose their flexibility and elasticity while the ligaments surrounding the discs can become brittle and are more easily damaged or torn. Because this can put pressure on spinal nerves (radiculopathy) or on the spinal cord (myelopathy), it can cause painful symptoms.
The symptoms most commonly experience with a herniated disc are:
- Neck pain
- Pain that radiates down the arm
- Numbness or tingling in the arm or hand
- Weakness in the arms (definite reason to consult a specialist)
As it is not possible to detect a herniated disc with an X-ray alone, an MRI is usually ordered to verify the diagnosis of a herniated disc especially if the doctor suspects another condition or needs to determine which nerves are affected. CT Scans may also be used to rule out other conditions. A Myelogram may be used in some cases, where a dye is injected into the spinal fluid, and then an X-ray is taken. This procedure can show pressure on your spinal cord or nerves due to multiple herniated discs. It can also assist in ruling out spinal cord tumors, abscesses and bony overgrowths.
Under normal circumstances, a cervical herniated disc can be treated conservatively and our multidisciplinary approach at SCCNS provides patients options when dealing with pain associated with herniated discs. Before we consider surgery as an option we treat with conservative measures such as:
- Modified activities
- Physical therapy directed exercises
- Cervical traction
- Oral medications to relieve pain and inflammation
- Epidural steroid injections
Unfortunately not all herniated discs can be treated conservatively. If it is found that conservative measures are not working and surgery is necessary, the experts at SCCNS will perform the most minimally invasive procedure required to treat the problem.
The most commonly preferred method of surgery for a herniated disc is an Anterior cervical discectomy and spine fusion (ACDF). During this surgery, the disc is removed through a small one-inch incision in the front of the neck. After removing the disc, the disc space is fused. A plate may be added for added stability and a better fusion rate.
A Posterior cervical discectomy can also be performed for large soft disc herniations that are lateral to (to the side of) the spinal cord. One advantage of this approach is that a spine fusion does not need to be done after removal of the disc. This preserves the normal motion of the cervical spine and may provide for a shorter healing time. However the disadvantage is that the disc space cannot be jacked open with a bone graft to give more space to the nerve root as it exits the spine. Also, since the posterior approach leaves most of the disc in place there is a small chance that a disc herniation may recur in the future. In addition, because the spinal cord is in the way, visualization of the disc space is limited and typically only a disc herniation that is lateral can be approached this way.