A herniated cervical disc is the consequence of the rupture of a degenerated intervertebral disc at some point of its circumference, and the gel-like center of the spinal disc bulging out and exerting pressure on a cervical nerve root. Symptoms and areas affected by pain will vary depending on the cervical area in which the hernia occurs. If the lesion is between discs C4 and C5, the pain will probably be located in the shoulder region; between discs C5 and C6, you could experience a weakened biceps, in addition to pain and numbness of the area near the thumb; between discs C6 and C7, you could suffer arm numbness and pain that includes the middle finger, and between discs C7 and T1, you will usually feel pain in your ring and little fingers, so picking up objects could be difficult.
It must be kept in mind that the cervical vertebrae are continually under stress. We force our cervical bones, ligaments and muscles when bearing weight loads inadequately, and as the day progresses, the cervical region ends up rigid or sore. Injuries in this area are one of the most frequent problems we encounter and can range from a simple muscle contracture to disk hernias or osteoarthritic osteophytes that exert compression on the spinal cord or nerve roots.
Non-surgical or conservative treatments to treat cervical disc disease initially consist of three types of medications: pain-killers or analgesics, anti-inflammatory drugs and muscle relaxants, and, occasionally, neuroleptic drugs in cases of severe pain of neurological origin. It is essential to combine drug treatment with physiotherapy and exercise, and it is also necessary to determine if daily habits should be changed to prevent new episodes of pain (for example, lifting excessive weights or engaging in physical activities that cause the spine to vibrate or undergo excessive pressure), and to reduce excessive body weight. If expected results are not achieved after a period of one or two months, you should consult your doctor again to discuss the different surgical options available to reduce pain and to replace the damaged disc if this should be necessary.
In cases of cervical pain with little or very limited local extension, and without marked
myelo-radicular compression, treatment with infiltrations or pulsed radiofrequency facet joint rhizolysis may be considered as the next step. These treatments are performed under local anesthesia in the operating room without requiring hospital admission. Sometimes they are used as sole treatments, and at other times are prior to, or complementary to, surgical procedures.
In cases that require cervical hernia surgery, the most frequent procedure is a cervical microdiscectomy with a cervical anterolateral approach. This approach allows a safe and minimally invasive access to the cervical spine, avoiding damage to the paravertebral muscles and excessive manipulation of spinal cord and nerves, and facilitating complete resection of the damaged disc and nerve decompression by microsurgery. The degenerated disc must be replaced by an artificial substitute. At Instituto Clavel we believe that Artificial Disc Replacement (ADR) surgery or disc arthroplasty is a better alternative to fusion surgery and much less aggressive, since it makes it possible to preserve the natural mobility of the spine. It consists in replacement of a degenerated cervical disc by an artificial implant designed to mimic the healthy natural disc in its axial compressibility and 360-degree flexion.
In some cases, however, the degeneration of the structures of the cervical spine is already excessive, causing segmental instability. These will require a fixed implant to achieve correct arthrodesis or intervertebral fusion.
Exceptionally, a posterior cervical approach may be necessary to achieve correct spinal decompression in very severe cases with several spinal levels involved.
At Instituto Clavel we use cutting-edge technology to perform procedures that will help patients to recover their well-being and improve their quality of life, reducing all pain and discomfort caused by cervical hernias.