What Is a Cervical Disc Herniation?
Cervical disc herniation is a pathological process of disc degeneration. The degeneration at the beginning indicates that the stability of the segment is weakened. Degeneration does not necessarily cause herniated discs, and herniated discs do not represent clinical pathogenesis, only predicting clinical pathological basis of spinal cord or nerve root compression. Therefore, it is not appropriate to list cervical disc herniation and cervical spondylosis as the same disease. Disc herniation refers to the protrusion of the nucleus pulposus and the corresponding fibrous ring into the spinal canal without or mildly associated with hyperplasia of subchondral bone and osteophyte formation in this segment of the vertebral body; under certain conditions, the disc degeneration and phase appearance Adjacent segment osteophyte formation does not cause clinical pathogenesis. Once the fibrous annulus of the intervertebral disc is ruptured and the degenerated nucleus pulposus prolapses, the spinal cord or spinal nerve root is compressed and becomes diseased. As the compressive substance is pure disc tissue, it is called cervical disc herniation.
Basic Information
- nickname
- Cervical process
- Visiting department
- orthopedics
- Multiple groups
- Young male
- Common locations
- Cervical spine
- Common causes
- Neck trauma, or degenerative degeneration of the disc, external force ruptures the fibrous annulus and posterior longitudinal ligament, and the nucleus pulposus protrudes, causing compression of the cervical spinal cord or nerve root
- Common symptoms
- Severe pain or numbness in unilateral upper limbs or hands, or numbness; weakness in strides, gait instability; neck discomfort, pain with shoulder aches
Causes of cervical disc herniation
- The onset of cervical disc herniation is based on the occurrence of degenerative changes in the intervertebral disc. After a certain external force, the fibrous ring and the posterior longitudinal ligament are ruptured, and the nucleus pulposus protrudes, causing the cervical spinal cord or nerve root to be compressed. Acute cervical disc herniation is caused by neck trauma. The main cause of injury is sprained neck caused by the rapid movement of the head due to accelerated violence. It is more common in traffic accidents or sports. The most severe disc injury is caused by cervical hyperextension-accelerated injury.
Clinical manifestations of cervical disc herniation
- In the early stage of the disease, it can be caused by slight strain, or even stretched when you wake up. Later relapses can be acute or chronic. Its first symptoms are the following four:
- 1. Unilateral upper limb or hand severe pain or numbness, or weakness numbness;
- 2. Weak stride, unstable gait, often beat soft legs;
- 3. Neck discomfort, pain with sore shoulder fatigue;
- 4. Numb hands and gait instability, easy to fall.
Cervical disc herniation
- 1. X-ray film
- X-ray examination showed reduced cervical curvature or trapezoidal change, narrowed intervertebral space, and showed degenerative changes. In young cases, the intervertebral space may not change significantly.
- 2.CT
- CT can accurately display the position, size and shape of the disc herniation, and can accurately determine the scleral sac, nerve root compression and the effective sagittal diameter of the spinal canal, providing a reliable basis for surgery and clinical non-surgical treatment.
- 3.MRI
- MRI can more accurately show the position, size and shape of the disc herniation, and can accurately determine the compression of the dural sac and nerve roots. Adjacent vertebrae often show signs of bone degeneration. Often one or more disc herniations are combined.
Diagnosis of cervical disc herniation
- The diagnosis of cervical disc herniation mainly depends on the comprehensive diagnosis of medical history, clinical manifestations and imaging examination. The main diagnostic points are:
- Medical history
- The spinal cord is compressed by the protruding disc, and most patients have no obvious and clear sensory disturbance plane, which may be caused by the blood supply to the ventral anterior central artery of the spinal cord.
- 2. Signs
- Early diagnosis of cervical disc herniation is of positive significance. Positive reactions are considered signs that impair the typical pyramidal tract. Neck discomfort and gait instability.
- 3. Imaging examination
- X-ray examination showed reduced cervical curvature or trapezoidal change, narrowed intervertebral space, and showed degenerative changes. CT examination can accurately show the position, size and shape of the disc herniation, and can accurately determine the dural sac, nerve root compression and effective sagittal diameter of the spinal canal. MRI is the most accurate clinically targeted cervical disc herniation This method can directly display the location, size and type of cervical disc herniation, the compressed nerve, the dural sac and the degree of nerve compression, etc., and provides a scientific basis for the diagnosis and treatment of the disease.
Cervical disc herniation treatment
- Cervical traction
- It can be taken in a sitting or lying position to keep the cervical spine in a slightly flexed position during traction; continuous traction is effective. Applicable to lateral cervical disc herniation, usually 2 weeks as a course of treatment.
- 2. Collar braking limitation
- If the neck is overactive and the symptoms are relieved after traction, the application of collar protection will help the recovery.
- 3. Physical therapy
- Wax therapy and hydrogen ion penetration therapy are better, and can be selected for light cases.
- 4. Drug treatment
- Chinese medicines for promoting blood circulation and removing blood stasis and sedative pain medicines can be appropriately used, which have a certain effect on relieving the disease.
- 5. Surgical treatment
- When it is confirmed that a pressure-producing substance such as a protruded disc, a fractured piece or a hematoma is present, decompression surgery should be performed in time, and the stability of the cervical spine should be reconstructed.
Prognosis of cervical disc herniation
- Because cervical disc herniation is a pathological process of disc degeneration, the degeneration of the segment at the beginning indicates that the stability of the segment is weakened. Based on the degenerative change of the disc, the fibrous ring and the posterior longitudinal ligament are affected by external force Rupture and nucleus pulposus protrude and cause compression of the cervical spinal cord or nerve root, so the prognosis is often poor.
Cervical disc herniation prevention
- 1. The pillow should be able to support the physiological curve of the cervical spine and keep the cervical spine straight. You can also lie down on the pillow and lie on a hard bed;
- 2. Protect the neck from "whip-like" injuries;
- 3. Perform appropriate functional exercises for the neck, such as doing "meter" exercises;
- 4. Keep your neck warm. The neck irritation can cause muscle and blood vessel spasm and aggravate neck injuries.