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Cervical disc herniation

What is Cervical disc herniation?

Cervical disc herniation is a condition where a disc in the cervical spine (neck) has slipped out (herniated) of its normal place between the vertebrae. The herniated disc can compress the nerves exiting from the cervical spine and going down the arms and into the hand. Occasionally the herniated disc can compress the spinal cord directly and cause myelopathy.

What causes it?

It is difficult to attribute a specific cause to cervical disc herniation.

What are the symptoms/effects?

When the disc compresses the nerve root it can cause pain radiating down the arms and occasionally into the hands. The nerve compression may also be associated with muscular weakness and numbness in the arms and hands.

Direct compression of the spinal cord causes myelopathy which is characterised by in-coordination of the hands, difficulty in walking and loss of walking balance and occasionally muscular weakness and numbness in the upper and lower limbs.

How is it diagnosed?

Cervical disc herniation is diagnosed by a clinical examination of the symptomatic person and confirmed with an MRI scan. The MRI scans reveals which disc has herniated and the size and extent of neural compression.

What are the treatment options?

A majority of patients can be managed without surgery and the pain subsides in six to twelve weeks. During this phase, the patients are advised to stay active within the limits of their pain. A course of oral steroids may be beneficial in some instances and non-steroidal anti-inflammatory medications (NSAID’s) can help manage the pain.

Surgery is indicated when there is a) failure of symptoms to subside after non-operative treatment, b) significant or worsening weakness in the arms and hands at presentation and c) myelopathy.

Who is at risk?/How can I prevent it?

Since we are unaware of the exact cause of the disc herniation, it is not possible to identify individuals at risk and suggest preventative measures.