Introduction
You can find more extensive information on this topic on our main page Herniated disc of the HWS The cervical spine consists of seven cervical vertebrae. The intervertebral discs are each located between two vertebral bodies of the spine and are responsible for the mobility of the spine. It consists of two parts of an outer zone, the annulus fibrosus and a gelatinous core, the nucleus pulposus.
In the context of a herniated disc, the nucleus of the disc (nucleus) shifts towards the spinal canal or a nerve root and breaks through the outer zone of the disc. The exited nucleus can constrict the spinal cord and thus lead to the typical symptoms of a herniated disc. The cause is usually the ageing of the intervertebral disc with increasing age.
In addition, with age, bony attachments to the vertebral bodies lead to an additional narrowing of the cervical canal in which the spinal cord is located. The most frequent occurrence of a slipped disc is in the cervical spine between vertebrae C5 and C6. Depending on the height of the herniated disc, different parts of the upper arm and hand can be affected.
Muscle paralysis and numbness may occur. At the most common height C5/C6, pain or sensory disturbances characteristically occur in the area of the upper arm, the thumb-side part of the forearm and the thumb, as well as loss of the biceps brachii muscle and the brachioradialis muscle. A herniated disc of C6/7, in contrast to a herniation at the level of C5/C6, results in a (partial) loss of the triceps muscle as well as pain in the index, middle and ring fingers. Any sensory disturbances also occur at these sites.
Before the operation
In any case, imaging of the cervical spine is necessary before an operation. Only if the location of the herniated disc and the clinical symptoms are identical, an operation makes sense. A CT (computed tomography) or an MRT (magnetic resonance imaging) are possible.
While CT is particularly good at imaging bony structures of the spine, MRI is used to visualize soft tissues, including the intervertebral discs and spinal cord. Before surgery is recommended for a herniated disc, it is treated conservatively. In addition to pain therapy (e.g. with ibuprofen), the focus is on physiotherapy with movement and special exercises for a herniated disc in the cervical spine.
In most cases a herniated disc can be successfully treated with these measures. If the conservative therapy does not bring any improvement within 6 weeks or if there are neurological symptoms, such as paralysis (pareses) up to the beginning paraplegia, sensitivity disorders, bladder or intestinal disorders, an operation should be performed. A further indication for surgery is the worsening of already existing symptoms.
All articles in this series:
