Neck Hernia (Cervical Disc Herniation)
Cervical Disc Herniation is a condition when the structure called the disc, located between the vertebrae, presses towards the nerve resulting in the loss of its normal structure and function. This disease most commonly occurs in the 30s and 40s of life. The herniated structure may compress the spinal cord or the nerve root protruding from the spinal cord, and the complaints it causes may vary accordingly. Most frequently, patients apply to the doctor with the following complaints:- Neck pain
- Pain radiating to the shoulder, arm, elbow, and hand
- Numbness in fingertips
- The loss of sensation and weakness on the side of pain
- Pain in the back and shoulder blades
- Sometimes comorbid headache
- Dropping objects
- Impairment in fine motor skills (buttoning etc.)
- Gait disturbance, imbalance
Being in front of the TV and computer for a long time, inappropriate sleeping and working positions, inappropriate posture, stress, fatigue, and traumas that cause uncontrolled back and forth in the neck region (in-vehicle traffic accident) cause cervical disc hernia.
Diagnosis: After listening to the patient's complaints, the examination is performed. It should be kept in mind that a certain part of the patients who apply only with shoulder pain have an underlying cervical disc hernia. For this reason, examination is very important. It will not be difficult to diagnose the disease with X-ray, tomography, and MRI films made afterward. However, the point to be known is that there is no rule that every hernia seen in the neck MRI will cause a complaint in the patient. A nerve conduction test called an EMG may be required to clarify exactly where the pain originates.
Treatment: The majority of patients can be treated with drug therapy and physical therapy methods, followed by exercises.
Especially in patients with arm pain and numbness, a controlled cortisone injection can be applied around the nerve with a thin needle.
However, surgical treatment is considered in patients whose pain does not go away despite all these treatments, who have weakness, balance disorder, difficulty in walking, and whose quality of life is impaired.
During the surgical treatment, the pressure of the disc or discs on the nerve, which is responsible for all these complaints, is removed by some surgical methods. These surgical methods can be classical open surgeries as well as minimally invasive methods called endoscopy. Microsurgery and discectomy are the most frequently applied surgical methods with very successful results today. Depending on the surgeon's preference, the procedure can be terminated by removing only the piece of the disc pressing on the nerve (microdiscectomy), or by applying a cage or disc prosthesis to the completely emptied disc space in order to prevent future flattening or even humpback. The aim of disc prosthesis, which has been popular in recent years, is to prevent the loss of neck movements as in the cage and to preserve the movement. However, in some scientific studies, it has been reported that after a while, there may be a loss of movement in the operated area despite the disc prosthesis.
The results of cervical disc hernia surgery are highly satisfactory. In the patient whose nerve compression is removed appropriately, the pain disappears quickly and the patient is up and discharged the next day. Nutrition with liquid foods is recommended for swallowing difficulties that may last for several days. If there is no special condition after the surgery, it is not necessary to use a neck brace.