The discs between the vertebrae along the spinal column act much like shock absorbers, as well as giving the spine the ability to move, or articulate. When the spine is twisted too far, or the torque on the spine is too much, a disc may bulge, or herniate. This means that the jelly-like substance inside the disc has pushed through small tears or cracks in the capsule that surrounds the fluid.
Many people experience a small amount of bulging or herniation as they age and they rarely have symptoms of pain or discomfort, other than a little localized tenderness or strain.
Conservative Treatment
However, when a person experiences a herniated disc in the neck (or cervical area) due to injury, a more moderate amount of pain may occur, as well as shooting pains down the arms, and in some cases the legs, leading the person to seek out medical advice. Most doctors recommend a conservative treatment of heat and ice, over-the-counter pain medication like Advil or Tylenol, and limiting movement of the area as much as possible, followed by range-of-motion exercises to strengthen the muscles surrounding the spine.
Surgery
If after six to twelve weeks the conservative treatment fails to give relief from pain and other symptoms, a surgical consultation may be recommended. Surgery may be recommended immediately if the person experiences severe pain and disability, or if weakness in the arms or legs becomes progressively worse.
When surgery is seen as necessary, a doctor may order additional diagnostic tests, such as an MRI (magnetic resonance imagery) or CT scan of the area to get a better look at the injury prior to surgery.
Two Primary Kinds of Surgery
There are primarily two kinds of surgery for a herniated disc of the neck. The first method has a lower risk of infection and a recovery time that is faster. This is when the surgeon makes a small incision and inserts a miniscule camera to view the injured disc. The surgeon then will either remove the disc entirely or will repair it. The second type of surgery involves a larger incision, allowing the surgeon to view the injury firsthand as well as determine if there are other problems in the area. This method has a slightly higher risk of infection and a longer time of recovery.
In both methods, when the disc is removed, the vertebrae are usually surgically fused together, and a small plate may be inserted to ensure stability. Minimal cutting of muscle tissue is general for types of surgery and incisions are rarely longer than two inches.
For additional information on neck surgery for herniated disc repair, check out the Orthopedicsurgerybook.com site on herniated disk neck surgery here.
Recovery Time
Often, the surgery can be completed on an outpatient basis or with a one-night stay in the hospital. During recovery, your surgeon may have you wear a neck brace to stabilize the area and prevent injuring the area again. Of course, each patient will vary in the amount of pain experienced, but usually pain after the surgery is minimal. The time to recover will also differ from person to person. The patient may need to limit activities for a period of time until complete fusion takes place.
Reliability
Cervical herniated disc surgery is very reliable with an experienced orthopedic surgeon. It carries a success rate of about 95 to 98% in terms or providing relief from debilitating pain down the arm.
Potential Risks
All major surgery has possible risks involved, with an experienced surgeon serious complications should be rare. Possible complications from neck surgery can include the following:
- The trachea/esophagus or one of the major blood vessels in the (front of the neck may be damaged. This happens in about 1 in 1,000 cases.
- Hoarseness can occur due to retraction on the nerve in the voice box. This happens in only 1% of cases and usually resolves in two to three months.
- In cases where surgical fusion is needed, there may be an occasional postoperative nonunion. This requires a second operation to refuse the vertebrae.
- A 1 in 10,000 chance of having either damage to the nerve root, or some type of spinal cord damage.
- After surgery, a leak of cerebrospinal fluid or infection of this fluid happens less than 1% of the time.
Summary
Treatment for cervical herniated discs start out conservatively, with doctors prescribing immobilization or limited movement of the area affected, over-the-counter medications or short-term prescription medications for pain, physical therapy and time. If the pain or other symptoms do not improve in six to twelve weeks, or if the patient is debilitated by pain and unable to complete activities of daily living (walking, dressing themselves, etc.) then surgery may be recommended.
Neck surgery for a herniated disc is generally completed on an out-patient basis, or a one-night stay in the hospital. Recovery time and post-operative pain varies from patient to patient, depending upon severity of injury, length of incision, general health of the patient and other factors.