CERVICAL DISC HERNIA
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The spine, which allows the body to stand upright, consists of 33 bones called vertebrae , through which the spinal cord passes. The vertebrae are connected to each other by a soft disc and two superficial joints. Consisting of strong connective tissue, the disc is the most important structure that connects one vertebra to another.
In the disc, there is a cartilage tissue that meets the pressure on the vertebrae as a shock absorber.
With movements such as wrong or wrong movements or lifting weights, the muscles contract and these ligaments are compressed. In addition, as we age, the center of the disc loses its water content, making the disc unable to cushion as well as before.
When the disc is damaged for these reasons, its outer layer may also rupture and the cartilage tissue inside the disc comes out of a tear in the outer layer and overflows into the space where the nerves and spinal cord are located. This also causes neck hernia. This overflow creates various complaints as it presses on the nerves going to the arm and spinal cord .
Neck Hernia ( Cervical Disc Herniation )?
Neck hernia traumas , strains, accidents, or loss of the central water content of the disc as we age can make the disc unable to cushion the disc as well as before.
As the disc continues to deteriorate, its outer layer may rupture and the center of the disc protrudes through a tear in the outer layer and protrudes into the space where the nerves and spinal cord are located, causing a herniated disc.
Our neck consists of 7 vertebrae and there are discs between our vertebrae that allow us to move. The disc, which is the most important structure connecting one vertebra to the other, is made up of strong connective tissue and acts as a cushion or shock absorber between the vertebrae.
Disc and facet joints allow movement of the vertebrae, making it possible for you to bend or turn your neck and back. Disc, " annulus a durable outer layer called the "fibrosus " and " nucleus" It consists of a jelly-like center called pulposus .
Reasons
Neck hernia occurs between the ages of 20-40, usually in people who use their body a lot. Lifting heavy loads, performing a reverse movement, and frequent pushing increases the risk of rupture of the connective tissue, that is, hernia. Traffic accidents or falling from a height are among other causes.
In addition to these, this discomfort occurs frequently in those who sit at a desk or computer for a long time, which causes poor posture.
Prolonged use of the mobile phone, looking at the screen for a long time by bending the neck, or talking by holding the phone to the neck can also cause neck hernia.
Keeping the phone or tablet below eye level and looking at it for a long time poses a risk for neck hernia.
Although there is not a complete genetic transmission, the risk of neck hernia in children whose parents have this disease is higher because genetic factors can be effective in the sensitivity of the disc joints.
Symptoms
The most prominent symptom of neck hernia is neck pain. But not all neck pain is caused by a hernia. Most of these are caused by muscle pain. Neck hernia occurs due to forcing and heavy lifting.
Pain due to hernia; pain in the back, shoulder blade, shoulder, back of the head and fingertips. Apart from pain, in advanced hernias, numbness, tingling and loss of strength may occur in certain areas of the arms and fingers, depending on the function of the pinched nerve.
- Neck pain: It can radiate from the back of the head to the temples. It is seen as severe, persistent pain radiating to the arm.
- Pain in the back, arms and shoulders
- Decreased dexterity
- Numbness and tingling in arms and fingers
- sensory loss
- Electrification
- Weakness in arm and hand muscles
- Weakening in reflexes
- thinning of the arm
Very rarely, a herniated disc can press on the spinal cord and cause problems in the legs. Numbness in the feet, urinary and stool incontinence can be seen very rarely.
When the nerve root or a spinal cord tissue is compressed, edema may occur in that area. Since edema also increases the pressure, discomfort can enter a vicious circle.
Diagnostic Methods
In the examination to be made by your doctor, the type and location of the pain is tried to be determined, and any loss of strength, loss of sensation and abnormal reflexes are checked.
Your doctor can use X-ray, MRI and Computed Tomography (CT) method for definitive diagnosis.
X-rays can show bony prominences and narrowing of the disc spaces that occur as the spine wears and deteriorates, but not herniation of the disc or nerves emerging from the spinal cord.
The pressure of the hernia on the spinal cord and nerves can be clearly seen on MRI . EMG, which shows nerve qualities and numbness of the nerve going from the neck to the arm for another reason, and tomography (CT), which shows the channel through which the nerves pass or a calcified disc or destroyed bone structure, are also used in the diagnosis of neck hernia.
How is Neck Hernia Diagnosed?
Careful examination of any loss of strength, loss of sensation, or abnormal reflex, in addition to a clinical assessment to determine the nature and location of the pain, is usually sufficient to diagnose and locate a disc herniation .
Your doctor's diagnosis is confirmed by X-rays, computed tomographs, or magnetic resonance imaging. X-rays can show bony prominences and narrowing of the disc spaces that occur as the spine wears and deteriorates, but cannot show disc herniation or nerves emerging from the spinal cord.
CT and MRI scans provide detailed images of all spinal sections (vertebrae, discs, spinal cord and nerves) and detect most disc herniations . In addition to all these, electrodiagnostic test studies can be performed to search for signs of nerve damage that may occur as a result of a herniated disc.
Treatment Methods
What are the Non-Surgical Treatment Methods for Neck Hernia?
neck hernia ( cervical disc herniation ) recover without any treatment. There are different options for the treatment of patients with ongoing pain. There are many drugs available to reduce the pain associated with neck hernia.
Most patients will improve with non-surgical medical treatment or conservative treatment. If your doctor deems it necessary, rest, neck brace, anti- inflammatory drugs to reduce nerve irritation, painkillers for pain control, physical therapy, exercise or epidural steroid He or she may recommend treatments such as injections .
The aim of non-surgical treatment of neck hernia is to reduce the irritation of the nerve caused by the herniated disc, relieve pain and improve the general condition of the patient. You should definitely ask your doctor whether you will go to work during the neck hernia treatment process.
Short-term (1-2 days) rest may be beneficial after the onset of pain due to neck hernia ( cervical disc herniation ). Restarting movement after this short rest is important in terms of preventing joint stiffness and muscle weakness.
can inform you about this by teaching you special exercises to strengthen your neck with the help of a nurse or physiotherapist .
You can perform these exercises at home, or you may need to see a physiotherapist for a more specific program that suits your needs and skills . The exercises should be done exactly as your doctor or physiotherapist told you.
neck hernia surgery
Surgery may be necessary for patients who are diagnosed with neck hernia but do not benefit from non-surgical treatment methods.
The purpose of neck hernia surgery is to remove the part of the disc that is pressing on the nerve. This is done through a procedure called a discectomy . Depending on the location of the herniated disc, the surgeon makes an incision in the anterior (figure-2) or posterior side of the neck to reach the spine (figure-3).
The technical decision about whether to perform the surgery from the front of the neck or the nape is determined by many factors such as the exact location of the disc herniation , the surgeon's experience and preferences. In both approaches, the portion of the disc pressing on the nerve is usually removed with good results.
In the anterior approach, since most of the disc will be removed to reach the herniated disc part, a fusion procedure usually performed in the same session is also necessary.