Prof. Dr. Erkan Kaptanoğlu

Diseases

Neck Hernia (Cervical Disc Herniation)

Neck (cervical disc) hernia is the condition where the disc material (pads) located between the cervical vertebrae is ruptured, fragmented and displaced into the canal as a result of aging or trauma, and causes compression to the spinal cord and the nerve roots.

Who Experiences Neck Hernia?

Almost all adults experience severe neck pain or stiffness at least once in their lives. Not every neck pain indicates neck hernia. Neck hernia is a condition commonly seen in middle-aged adults. It is important to know the risk factors that increase the incidence of neck hernia.

What Are The Risk Factors?
  1. Disruption of discs depending on age.
  2. Trauma caused by traffic accidents and impacts.
  3. Lifting heavy objects.
  4. Continuously working with an inappropriate neck position (e.g. continuous computer use) and inactivity.
  5. Smoking.
How To Avoid Neck Herniation? What Are The Risky Positions and Moves?

The majority of neck pains is caused by the weakness of the neck muscles or deformities in the joints and bones. In most cases, pain arising from the shoulders may be confused with neck hernia. Strengthening of the neck muscles plays an important role in the prevention of neck hernia. It is possible to strengthen the neck muscles with a few exercises. Additionally, if there is no heart issue, it would be beneficial to use moderately firm or soft pillows that are not too high. The neck should be on the same level with the shoulders when lying on your back and excessive bending of the neck to forward and back must be avoided. Using monitors at the same level as your head may reduce pain in case of prolonged computer use.

What Are The Symptoms Of Neck Hernia?

Only one of the following symptoms may be seen, or multiple symptoms may coexist.

  1. Neck or shoulder pain (the pain may keep you awake at night).
  2. Pain spreading from the back of the neck to the head.
  3. Restlessness in one or two arms.
  4. Severe pain, aching in one or both arms.
  5. Weakness in one or both arms or hands. For example, dropping the objects, such as cups, that you are holding.
  6. Numbness or felting in one or two arms.
  7. Symptoms of impaired urinary or fecal control may be seen.
  8. Dizziness, imbalance while walking.
How is Neck Hernia Diagnosed?

Magnetic resonance imaging (MRI), which is one of the modern diagnostic methods, can easily diagnose the neck hernia and determine its severity. EMG (Nerve Measurement Test) is also required in some cases. Computed tomography (CT) is very good in demonstrating the structure of the neck spine bones. However, the most important criteria in the diagnosis of neck hernia are clinical examination and the physician’s experience in observation.

What Are The Treatment Methods For Neck Hernia?
Inception Phase

The treatment of neck hernia depends on the extent of herniation, that is, the amount of pressure exerted by the elastic material we call a disc on the nerves leading to the arm and the spinal cord. If only a reasonable degree of neck or arm pain is present, and there is no numbness, loss of strength, and restriction of movement, this means that the neck hernia is in its initial stage. In this case, analgesics, non-steroidal anti-inflammatory drugs, and muscle relaxants may be given to the patient. It is recommended to have bed rest and avoid movements that will force the neck. Recommendations to the patient are:

  1. The patient should not lift weights exceeding two to three kilograms (five to six pounds)
  2. Should use a short-term neck collar
  3. If there is no heart disease, should use a low and soft pillow in bed
  4. Should do exercises daily to strengthen neck muscles
  5. The patient should always keep his neck warm and should not stand in front of open windows or in the way of drafts.
  6. Patients with neck and arm pain should always avoid stress. Stress can increase the pain as well as the progression of the neck hernia.
  7. Should not spend too much time in front of the computer or television in an improper position.
If The Neck Hernia Advances

If the patient’s complaints persist despite the foregoing recommendations, rest and muscle relaxants, physical therapy may be administered. Physical therapy must be supervised by an expert. There may be an increase in pain during the first few days of physical therapy, but the patient should carry on with the treatment for the duration recommended by the physical therapist.

Conditions That Require Surgery

In spite of physical therapy, if the patient’s pain persists or if there is loss of strength, sensory loss and numbness, surgical intervention is the solution.

How Is Surgical Treatment Administered?

Today, the most commonly used surgical method is microscopic disc surgery performed from the anterior part of the neck. Depending on the patient’s situation and the condition of the disease, special cages to replace the discharged hernia can be used, along with plate screws or prostheses in some occasions. Surgery can also be performed from the posterior part of the neck depending on the location of the hernia. The diagnosis of the disease, the extent and severity of the disease, how it affects the daily life of the patient and their needs, the physician’s approach and experience are important factors in choosing the treatment.

Expectations After Surgery

Most patients benefit quickly from neck hernia surgery. Neck and arm pain are expected to be cured after surgery. There may be a slight pain in the surgery site, which can be kept under control with painkillers.

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