There are seven cervical vertebrae and between each vertebra there are intervertebral discs whose function is to distribute the weight supported by the spine. Sustained overload, as well as many personal factors in each individual, mean that these discs degenerate and some of their fibres break down and permit movement of the nucleus pulposus, the central element of the disc. When this occurs it is referred to as a discal hernia.
Clinical signs:
In the initial phases of the profile the patient presents diffuse pain on a cervical level, this pain is due to degeneration of the intervertebral disc, in other cases the profile may be more acute with the onset of cervicobrachialgia (pain in the neck and arm). The location of the pain depends on the level where the hernia has occurred each level corresponds to a specific territory or dermatome.
Diagnosis:
Once clinical suspicion is established cervical MR imaging will be performed to determine the exact pathology, the diagnostic capacity of MR imaging is better than a cervical CAT scan and this is why it is recommended prior to surgery.
In some cases the study is complemented by an electromyogram (EMG), which will reveal the degree of affectation of the nerve root.
Treatment:
In those cases where remission of the pain is not achieved with pharmacological treatment, surgery will be the treatment of choice.
Nowadays the herniated disc is resected (cervical discectomy) and replaced by a prosthesis to prevent loss of height in the interdiscal space and thus avoiding deformation of the cervical spine.
