The cervical spine comprises all the vertebrae between the thoracic spine and the head. The intervertebral discs between the bones ensure the mobility of the cervical spine.
In the case of a herniated disc, the outer shell of the disc tears.
The gelatinous core protrudes from the tear and presses against the nerves of the adjacent spinal cord nerves and the spinal cord itself. This pressure causes various painful symptoms.
A slipped disc in the cervical spine can be treated conservatively in most cases.
Typical symptoms of a herniated cervical disc include neck pain, pain in the shoulder or arm, and numbness or tingling in the hand and arm. The range of complaints is very broad. The pain may be dull, but it can also feel like a burning sensation.
If a disc herniates in the direction of the spinal canal, it can cause compression of the spinal cord. This leads to disturbances in gait and sensory disturbances in the legs. Weakness and lack of coordination have also been reported.
The intervertebral discs change with age and lose their elasticity and flexibility. Herniated discs are therefore the result of wear and tear on the spine. The spine begins to deteriorate from the age of 20 years. Most cases of the disease appear between the ages of 40 and 45.
The process of wear and tear is exacerbated by heavy physical work, incorrect loading of the spine, and poor posture.
To diagnose a herniated disc in the cervical spine, the doctor will examine the neck, arms and legs of the patient. During the examination, the range of motion and flexibility of the neck is tested. The doctor will also check whether there are any signs of impairment of the nerve roots. The cervical spine is then examined with the aid of magnetic resonance imaging (MRI) or X-rays.
The treatment of a slipped disc is initially conservative, and relies upon pain medication, physical rest and relief, followed by physiotherapy.
If the pain persists, nerve root infiltration can help to alleviate the symptoms. During the CT scan or under X-ray fluoroscopy, the patient is administered an anti-inflammatory drug (cortisone) and the local anaesthetic lidocaine directly to the affected vertebra.
If conservative therapy does not bring about improvement, the herniated disc in the cervical spine is operated on. Surgery is also necessary if there is significant compression of the spinal cord, if the patient becomes paralysed, or if the condition is causing incontinence.
Various surgical methods are available, depending on the location of the herniated disc. Surgery to remove the extruded gelatinous core is often enough to relieve the pressure on the nerves. However, if the damaged intervertebral disc can no longer be preserved, it must be removed and replaced either with a piece of the patient’s own bone material or with an artificial intervertebral disc. The use of endogenous bone material ‘blocks’ the affected section and thus restricts the mobility of the cervical spine. The mobility of the cervical spine is maintained through the use of a disc prosthesis.
After the procedure, it is recommended that a soft neck collar is worn for four to six weeks. This collar prevents uncontrolled movements. After the hospital stay, the patient begins physiotherapy to stabilise the cervical spine. After six weeks, the patient can resume a normal daily routine. More taxing physical exertion is to be avoided for a period of time prescribed by the doctor.
That depends on the severity of the herniated disc and the type of treatment. With conservative therapy, the symptoms should subside after six to eight weeks. After a successful operation, the neurological limitations are usually eliminated immediately and after a few months there is a significant improvement in pain levels.