Neck Hernia

One third of the people suffer from neck pains at least once in their lifetime. Some of the neck pain is caused by cervical disc hernia, but an improper choice of pillow can also be a cause as well.

Discs comprise of a soft gel-like material called nucleus pulposus and a strong outer ring that surrounds this material called annulus fibrosus. The duties of discs are absorbing the load of upper segments and transferring it to lower segments equally. They also enable the mobility of the vertebrae by the help of facet joints. Any damage to this outer ring (annulus fibrosus) results in the gel-like material (nucleus pulposus) bulge out to the area of nerves in our spine. It then both causes compression and a chemical irritation on the nerves. The irritant effect of the released chemicals can cause a pain in the neck; and nerve compression can cause in the arms a tingling, hypokinesia and loss of strength. This disease is called cervical disc hernia.

Main causes for cervical disc hernia are lifting heavy weights, sedentary lifestyle (working desk jobs) or impacts against the head or neck.

When a patient consults a physician based on these problems, he/she goes through a physical examination of muscular power, sense and reflex; and a detailed medical history is taken as well. Then the radiologic analyses like X-Ray, Computerized Tomography (CT Scan) and Magnetic Resonance Imaging MRI are made according to physician’s suggestion. X-Ray shows the bone structures in the cervical area and CT Scan analyzes these structures in more detail. (MRI) shows a detailed image of the discs and nerves between cervical vertebrae. The most valuable information about cervical disc hernia is obtained via MRI. Electromyography (EMG) can also show us where there is nerve compression.

Patients that are diagnosed with cervical disc hernia are first treated with conservative methods which are also called non-surgical treatment methods. These methods include medication and physical treatment like cervical collar (neck brace). Medication treatment aims to cease the pain and increase the quality of life. Cervical collars are only used for short periods according to the physician’s suggestion and aims to relieve the reactive muscular contractions and spasms. Using cervical collar for a longer period weakens these muscles and starts to do more harm than good. Physical treatment also strengthens the cervical muscles and tissues, thus serving to a more stable spine. Spinal injections to cervical area are also among the non-surgical treatment methods which serve to decrease the chemical effects caused by hernia.

Patients whom the non-surgical methods fail, or have serious complaints about tingling, hypokinesia and loss of strength can be offered surgical treatment. Surgery allows cleaning the disc material that bulge out to central canal and compress the nerves that travel to extensor muscles. According to the size of overflowed and cleaned disc material, the two vertebral bodies on top of and under the disc can either be fused or a disc prosthesis can be attached in order to restore mobility. Small-sized discs may not require an extra process. The surgical operation may differ based on the patient’s age or the type and place of hernia. Patients are often discharged from hospital on the day of surgery and can return to their daily lives with normal routine in a very short time by the help of a postoperative rehabilitation program.

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