What is a Cervical Disc Hernia?
The spine consists of a series of interlinked bones, called vertebra. The vertebras surround the spinal cord and protect it from injury. The nerves branch from the spinal cord and travel to other parts of the body, thereby forming the link between the brain and the rest of the body.
The brain moves the muscles by a message carried by the nerves. The nerves also carry senses such as pain and heat from the body to the brain.
The vertebral bodies are connected to each other with one disc and two small joints, named facet joints. The disc is the most important structure that connects one disc to another. It is formed by a strong connective tissue, and acts as a cushion or shock absorber between the vertebras. The discs and facet joints enable movement of the vertebra, thereby making it possible to bend your neck or back, or to rotate them.
The disc is composed of a strong outer layer named "annulus fibrosus", and a jelly-like core named "nucleus pulposus".
With increasing age, the center of the disc begins to lose water content, and the disc cannot perform its shock absorbing function as much as it used to. The outer layer may also rupture as the disc continues to degenerate. This may cause overflowing (disc herniation or disc rupture) of the disc through a tear in the outer layer, and into the space that harbors the nerves and the spinal cord.
The herniated disc may then press against the nerves and cause pain, loss of sensation, tingling, and weakness on the arms and shoulders. Your doctor may detect changes in the strength of your muscles, reflexes, or senses. In rare instances, the herniated dics may cause leg problems by comressing the spinal cord.
How is it Diagnosed?
A clinical examination focused on finding the source and type of pain, and also a careful examination of any muscle weakness, sensory loss, and abnormal reflex are often enough to diagnose and locate discal hernia.
Your doctor's diagnosis will be confirmed with X-rays, computerized tomography, and magnetic resonance imaging. X-rays can show bony projections and narrowing of the disc spaces that occur with wear and degeneration of the spine, however it cannot show disc hernation or the nerves branching from the spinal cord. CT and MRI (the gold standard) enable detailed images of all structures of the spine (vertebrae, discs, spinal cord and nerves), and detect most disc herniations. In addition, by conducting nerve studies, nerve injury—possibly caused by a disc hernia—can be investigated.
What Treatments are Available?
Most patients with cervical disc hernia can improve without any treatment. In patients with persistent pain, there are a number of choices. Many drugs and non-surgical modalities will help decrease pain related to cervical disc hernia. Surgical treatment will be required for some patients.