Orthopedics: Conditions

Cervical Herniated Disc

What is a Cervical Herniated Disc?

Cervical discs are the cushions between the vertebrae in the upper back and neck. Herniation of the disc occurs when the gelatinous inner disc material, the nucleus pulpous, ruptures, or herniates, through the outer cervical disc wall.

Cervical Herniated Disc Symptoms

Symptoms of cervical herniated disc may include:

  • Pain that radiates down the arm to the hand or fingers
  • Numbness or tingling in the shoulder, arm, or hands
  • Weakness of hand and or arms

Certain positions or movements of the neck can intensify the pain. The symptoms of a cervical herniated disc often resemble other disorders such as carpal tunnel syndrome, problems with the rotator cuff, and gout.

In some patients, a cervical herniated disc can cause spinal cord compression, where disc material pushes on the spinal cord. This is a much more serious condition and may require a more aggressive treatment plan. Spinal cord compression symptoms include:

  • Awkward or stumbling gait
  • Difficulty with fine motor skills in the hands and arms
  • Tingling or "shock" type feelings down the torso or into the legs

Who is a Typical Cervical Herniated Disc Patient?

Cervical disc herniation is usually seen in 30- to 50-year-olds. It may be seen in patients in their 80s, but this is rare, as normal aging tends to dry out the disc, preventing rupture.

Cervical Herniated Disc Diagnosis

Your spine doctor will consider your medical history and symptoms and give you a physical examination, during which the doctor will look for limitations of movement in the spine, problems with balance, and signs of pain, as well as any loss of extremity reflexes, muscle weakness, sensory loss, or abnormal reflexes that may suggest spinal cord involvement.

After a physical examination, your doctor can use a variety of tests to get a closer look, including X-rays, MRIs, CT scans, CT myelogram, or bone scans.

Nonsurgical Treatment of Cervical Herniated Disc

All treatments for a cervical herniated disc are designed to help resolve pain. Most episodes of arm pain due to a cervical herniated disc will resolve over a period of weeks to a couple of months, and, usually, pain from a cervical herniated disc can be controlled with medication. Once the pain improves, it is unlikely to return, although it may take longer for the weakness and numbness/tingling to improve.

Interventional treatments for cervical disc herniation may include:

  • Physical therapy and/or exercises for exercises to help relieve the pressure on the nerve root
  • Medications, such as non-steroidal anti-inflammatory drugs (NSAIDs) to reduce swelling and pain and analgesics to relieve pain
  • Epidural steroid injections and nerve root injections to help reduce swelling and treat acute pain that radiates to the hips or down the leg

Surgical Treatment of Cervical Herniated Disc

If pain from a cervical disc herniation lasts longer than 6 to 12 weeks, or if the pain and disability are severe, spine surgery may be a reasonable option. Spine surgery for a cervical herniated disc is generally very reliable and can be done with a minimal amount of postoperative pain and morbidity (unwanted aftereffects).

With an experienced Emory spine surgeon, the surgery should carry a low risk of failure or complications. The success rate for spine surgery for a cervical herniated disc is about 95-98% in terms of providing pain relief.

Some of the surgical procedures used to treat cervical disc herniation at Emory are: