Neck Hernia (Cervical Disc Herniation)
What is Neck Hernia, How Does It Occur?
The spine consists of bones, which we call 'vertebrae', stacked on top of each other. In the middle of each vertebral body is the spinal cord, which is the continuation of the brain. The senses returning to the brain from various parts of the body or the orders dispersed from the brain to the body travel within the spinal cord. Nerves coming out of the level of each vertebral body in the neck region also spread to the arm and back, providing the sensation and movement of these regions. These bones, called vertebrae, are connected to each other by flexible structures called 'disc' which have elastic properties.
Over time, these flexible structures, namely the discs, wear out and lose their elastic properties. As such, this disc overflows backwards with traumas or loads. In other words, neck hernia occurs as a result of the gelatinous inner part of the discs tearing the outer part, which consists of a stronger connective tissue, and compressing the spinal cord and nerves. This herniation in the neck causes the pain we call 'radicular pain' that spreads from the shoulder to the arm to our fingers. Neck movements, especially moving the head back, can increase the pain.
What are the Symptoms of Neck Hernia?
The most common complaint is pain. Pain can be described in different ways, such as blunt, sharp, electric shock or stabbing. In the affected dermatome area, paresthesia or loss of sensation may occur. Neck movements are usually limited.
Pain, which is the main symptom, can spread from the cervical region to the occiput, neck muscles, shoulders and upper extremities. Various symptoms such as temporary or irreversible stiffness caused by pain, numbness, numbness, tingling, weakness in the upper extremities, dizziness, headache, imbalance increased with neck movements due to the involvement of vertebral arteries or sympathetic nerves can be seen.
What are the Treatment Methods in Neck Hernia?
The main goal of treatment is to reduce the pain sensation of the patients and to allow them to continue their daily life activities without pain. The sensation of pain, which occurs for various reasons, is the first reason for patients to apply to the clinic. In the acute period in patients who applied to the clinic with the diagnosis of cervical disc pathology; In order to control pain, edema and inflammatory condition, early mobilization, reducing the overload on the joints, protecting the injured tissues and exercises are the most basic treatment elements.
The application of non-steroidal anti-inflammatory drugs along with the application of ice on the affected area is beneficial in suppressing edema and inflammation. acute period; basic treatment techniques used in cervical disc pathologies; It is useful to apply a nonsteroidal anti-inflammatory drug to the affected area, as well as to apply ice to the affected area. With the reduction of inflammation, warm applications can be started later to relax the soft tissues. It is usually sufficient to reduce pain with physical therapy methods along with medical treatment. Short-term bed rest, use of assistive devices, and joint range of motion exercises can be given together with stretching and relaxation exercises if soft tissue tension is present. Chronic period; In cervical disc pathologies, the time required to reduce pain may be longer compared to the acute period. The main aim is to provide normal joint range of motion, to increase the strength, endurance and coordination of the cervical region and surrounding muscles, to accelerate the return to normal daily life activities and to prevent new injuries by leaving a permanent result of the treatment.
Surgical Treatment Surgical treatment may be necessary for patients whose pain is not relieved by medical treatment methods, who have significant loss of strength, and who have significant spinal cord compression. The aim of surgery is to remove the part of the disc that is pressing on the spinal cord and nerve. This is done by a method called discectomy. Depending on the location of the disc herniation, the surgeon performs the surgery through an incision made in the front and back of the neck to reach the spine. In both approaches, the pressure of the disc material on the nerve structures is eliminated.
Results are generally good. In the anterior approach, bone material and motion-preserving prostheses can be placed to provide fusion instead of the disc material, which is usually discharged between the vertebrae.