The cervical spine is the most superior part of your vertebral column, that lies between the cranium and the thoracic vertebrae. It consists of a series of small bones which make up your spine that supports your neck. It covers your spinal cord which sends signals from your brain to control the functions of your body parts. The cervical spine is a remarkably strong & flexible structure, which allows your neck to move in all directions.
The cervical spine comprises seven distinct vertebral segments (C1-C7 vertebrae) which are separated by the cervicals discs. These cervical discs are made of a soft gel-like substance and act as shock-absorbers in the neck between vertebrae.
What Is Cervical Disc Prolapse?
You might have heard the words “herniated disc” or “slipped disk”, a condition when the gel-like fluid in the centre of a spinal disc pushes out through the weak spot in the tough outer wall. Similarly, cervical disc prolapse is the herniation that occurs in the cervical spine.
The external part of a disk is built up of fibrous cartilage that holds the gel contained inside the disc. When the external part gets tears or splits, causing the gel-substance inside the nucleus pulposus pushes through a tear in the outer fibrous ring against the surrounding nerves in the neck.
What Are The Complications Of Cervical Disc Prolapse?
Cervical disc prolapse can sometimes cause permanent nerve damage. It is rare but a slipped disc can rip the nerve impulses. Rarely, the signs and symptoms of cervical disc prolapse may feel worse gradually rather than stabilizing and resolving on its own.
If the nerve root in the cervix remains pinched or inflamed, you may experience tingling, numbness, or weakness that may progress in the arm. In the same way, if the spinal cord is compressed due to cervical disc prolapse you may face problems like coordination, walking problems. These types of neurological problems require immediate medical treatment to prevent permanent damage.
What Causes A Cervical Disc Prolapse?
There were several causes for disc prolapse. As we age, our discs in the spine can lose their flexibility and elasticity because the gel in the discs may dry out. The ligaments surrounding the discs become brittle and are more easily torn. Disc prolapse occurs due to excessive stress on the disc, whether it might due to lifting heavy objects, injury or other damaging activities.
It is also hypothesized that herniated disks have a genetic preponderance and hence can also run in families. Smoking and several occupational activities might lead to early disc degeneration.
How To Treat Cervical Disc Prolapse?
Conservative or nonsurgical treatment is the first line of treatment preferred by most of the spine doctors for cervical disc prolapse or herniated disc problem. Over 95% of people with herniated disc problems recover within six weeks with the help of conservative treatment and return to regular activity. The nonsurgical treatment options for herniated disc problems include self-care, medication, physical therapy, home exercises, steroid injections, physiotherapy, and pain management.
Self-care: Caring yourself in case of a mild herniated disc problem, the condition gets better within a couple of days and resolves completely within 6 weeks. Ice/heat therapy, and taking OTC medications can help to recover faster.
Medication: A spine surgeon would suggest some pain relievers, NSAIDs, and steroids that provide relief from intense neck pain. Sometimes muscle relaxers are also prescribed for muscle spasms.
Steroid injections: The procedure involves the injection of steroids into the epidural space of the spine. The medicine delivered next to the herniated site to reduce the swelling and inflammation of the nerves. Nearly 50% of patients with cervical disc problems get relief after taking an epidural injection. The injections are repeated to achieve the full effect. However, a cervical epidural steroid injection is a very risky procedure and done only by very few experts.
Physical therapy: Physical therapy for disc problems plays a crucial role in conservation treatment as it helps you to return to regular activities as soon as possible and even prevent re-injury. Physical therapists instruct you on certain techniques, and they will work with you to strengthen your neck, shoulder muscles. They’ll help you to increase the flexibility of your cervical spine.
Outline Of Surgical Options For Cervical Disc Prolapse
If your condition doesn’t respond to conservative treatment or the symptoms getting worse surgery might be the only option left. Before surgery, many factors like patient age, the time period of the problem, other health problems, prior neck surgeries are considered.
Anterior approach(front of the neck) the most common approach to cervical disc surgery. For multilevel disc compressions with myelopathy , posterior approaches are considered.
Anterior cervical discectomy & fusion (ACDF): The procedure involves making a small incision in the front of your neck, and the ruptured disc pressurizing the nerve is removed. This procedure is used using the help of a microscope. After removal of herniated material, the disc space might be filled with a bone graft or a cage to build fusion. Fusion is a method of combining two or more bones. The bone graft is many times fixed with a small plate and screws.
Artificial disc replacement: During an anterior discectomy, an artificial disc-shaped device is inserted into the damaged area to provide natural motion. The artificial discs may be manufactured from metal or plastic.
Posterior cervical discectomy: In this procedure, a spine surgeon makes a 1to2 inch incision back of your neck to reach the prolapsed disc. A small section of the bony arch is also removed to get access to the nerve roots and disc space. The part of the herniated disc compressing the spinal nerve is removed carefully. Endoscope or microscope is usually used in the procedure
The recovery after surgery is based on the type of surgical procedure and varies from person to person. If you are experiencing neck pain or any back pain, consult a spine specialist immediately. For more information, contact Dr Surya Prakash Rao Voleti, one of the best spine surgeons in Hyderabad.