CERVICAL DISC HERNIATION

Cervical discs are soft pieces of connective tissue that act as cushions between the vertebrae in the upper back and neck and help hold the vertebra together properly. Herniation of the disc (commonly referred to as a “slipped disc”) occurs when the inner tissue of the disc ruptures (or herniates) through a tear in the outer disc wall.

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CERVICAL DISC HERNIATION

At Southwest Scoliosis Institute, our board-certified, fellowship-trained orthopedic physicians, Richard Hostin, MD, Shyam Kishan, MD, and Kathryn Wiesman, MD have treated thousands of patients with complex spine conditions, including herniated cervical discs.

While a herniated cervical disc can occur as the result of an injury or trauma, it’s more commonly the result of the gradual degeneration of the disc and weakening of the outer layer that keeps the disc in place. Because this occurs over time, patients often don’t notice the symptoms until they become severe.

Cervical disc herniation typically occurs in people between the ages of 30 and 50. It tends to affect older adults because as the discs and the tissue that holds them in place dry out, they are more prone to cracks and other injuries that can increase the risk of herniation.

Symptoms of a Herniated Cervical Disc

Herniated disc symptoms can differ depending on which part of the spine the herniated disc occurs and whether the nerve(s) is being compressed. In the case of a herniated cervical disc, symptoms often include:

  • Cervical Disc Herniation Pain is pain the neck that radiates down the arm towards the hands and fingers
  • Numbness or tingling in the shoulders, arms, or hands
  • Muscle weakness in hand and/or arms

In severe cases, a herniated disc may put pressure on the spinal cord. This is a much more serious condition that can cause pain, tingling, numbness, or weakness to be felt in both arms and possibly even lower in the body.

Symptoms of spinal cord compression may also include:

  • Difficulty walking straight or unsteady gait
  • A reduction in fine motor skills in the hands and arms
  • Painful tingling or feelings like electric shocks in the torso or even into the legs
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Herniated Disc Diagnosis

Your physician at Southwest Scoliosis Institute will go over your medical history and perform a thorough physical examination, during which they will specifically look for any signs of limited mobility and/or pain in the cervical spine.

The physician will also check to see if there is any difficulty with balance, as well as any reductions in muscle reflexes, loss of sensation, or muscle weakness that may be the result of spinal cord compression.

If a herniated cervical disc is suspected, the doctor will use X-ray imaging, computed tomography (CT) scans, or magnetic resonance imaging (MRI) to confirm the diagnosis. Because X-ray imaging can only show issues with the bones themselves and not the disc, nerves, and spinal cord, a CT or MRI scan may also be necessary.

Southwest Scoliosis Institute uses a state-of-the-art digital low dose radiation X-ray imaging system that can take high-quality images of patients in just 10-25 seconds. This system can also take X-rays of patients in a standing or seated position, and it’s conveniently located inside our Dallas location, meaning you and your physician can review the X-rays immediately after they are taken.

Treatment for a Herniated Cervical Disc

Treatment options for a herniated cervical disc range from physical therapy and medication to surgical intervention. At Southwest Scoliosis Institute, our orthopedic physicians always try to utilize a conservative approach to treatment before considering surgery, and they always take the time to carefully discuss all options with patients. Treatment for a herniated cervical disc depends largely on the age and overall health, as well as the severity of the herniation.

Nonsurgical Treatment

Most patients see improvement with nonsurgical treatments that are primarily designed to reduce the pain, inflammation, and muscle stiffness that accompany the herniated disc. Medication is usually enough to manage any pain, and any numbness or tingling sensations tend to improve with time and rest.

Nonsurgical treatments for cervical disc herniation include:

  • Physical therapy and/or exercises to relieve the pressure on the nerves
  • Medications to reduce swelling and pain, such as non-steroidal anti-inflammatory drugs (NSAIDs)
  • Epidural steroid injections and nerve root injections to reduce swelling around the affected disc and nerves, as well as to relieve acute pain radiating to the hips or down the legs.

Cervical Disc Herniation Surgery

If the pain, numbness, and other symptoms persist for more than 6-12 weeks, or if there is evidence of severe spinal cord compression, your physician may recommend surgery.

Surgical treatment includes:

Anterior Cervical Discectomy and Spinal Fusion. This procedure involves removing the herniated disc through the anterior (front) side of the neck in order to relieve the pressure on the nerves and/or spinal cord. Because most (if not all) of the disc will be removed, a fusion procedure is then performed to stabilize this portion of the spine. A fusion procedure typically involves a small bone graft as well as instrumentation (screws, rods, etc.) to ensure that the bones fuse properly and to retain the correct spacing between the vertebrae.

Posterior Cervical Decompression (Microdiscectomy). In cases where the herniation of the disc is minor, your physician may opt to use this procedure, which uses minimally invasive techniques to remove the portion of the herniated disc pressing on the nerve through a small incision on the posterior (back) side of the neck. Because only the small herniated portion of the disc is removed, this surgery does not usually need to be combined with a spinal fusion procedure.

“At Southwest Scoliosis Institute, we treat disc herniations based on symptoms. The initial treatments are physical therapy andmedications, the next set of treatments would be pain management injections, and ultimately, some people will require surgery to relieve the damaged disc and alleviate the nerve pain.”   Richard Hostin, MD

If you or a loved one suffers from spinal pain, you owe it to yourself to call Southwest Scoliosis Institute at 214-556-0555 to make an appointment.