Cervical herniated disc

The spinal disc is a cartilaginous structure that is located between the vertebrae. Its main functions consist of cushioning and distributing loads and acting as a link between a vertebral body and the adjacent one.

The intervertebral disc divided into two parts: the external annulus fibrosus and the gelatinous nucleus pulposus located in the central part. 

The main cause of cervical disc herniation is age. From the age of 20, the annulus fibrosus begins to progressively degenerate. Fissures occur, as well as disc protrusions and herniations of the nucleus pulposus. This is when neurological disorders and osteoarthritic degeneration of the cervical spine begin to emerge.

Cervical disc herniation is caused by the displacement of the nucleus pulposus posteriorly. On many occasions, it is caused by rupture of the annulus fibrosus, and two situations may occur:

The rupture of the annulus is incomplete and produces a contained deformation or disc protrusion. 

The annulus fibrosus breaks completely and the nucleus pulposus comes out, where the spinal cord and nerve roots to the neck, arms, and hands are found. 

The intensity or severity of the symptoms of cervical disc herniation depends on the compression of the root and/or spinal cord, which is what causes cervical pain.

Cervicobrachialgia, neck pain, or radiating neck pain to the shoulder, arm, and fingers occurs when compression affects a nerve root (radiculopathy). The pain is continuous, and causes night disturbances, tingling in the arm and/or hand (paresthesia), decreased sensitivity (hypoaesthesia), and dizziness.

When the herniated disc compresses the spinal cord, myelopathy occurs. The symptoms experienced by the patient are numerous: gait disturbance, sphincter involvement, or abnormalities in the sensitivity and strength of the lower and/or upper extremities.

On many occasions, complementary tests will be necessary, such as neurophysiological tests to study the pudendal nerve, electromyography to study the pelvic floor muscles, ultrasound and echo-Doppler to study the abdominopelvic arteries and veins, MRI and/or abdominal and pelvic CT, Stamey test, transrectal prostate ultrasound, etc.

In the case of herniated discs, it is important for the patient to identify the symptoms early, to prevent the progression of the injury. In this way, you can relieve the pain quickly.

The diagnosis of cervical disc herniation must be rigorous, and a thorough clinical history must be carried out that includes an exhaustive examination in the patient's consultation and an evaluation of the complementary tests that are performed:

• The magnetic resonance allows to clearly observe the existence of the cervical disc herniation. Currently, it is the most effective test to detect this pathology since it offers a very clear image of the nerve root impingement.
• With the lateral and anteroposterior projections of an X-ray, the degenerative state of the intervertebral discs can be verified and possible traumatic pathologies, such as fractures or dislocations, can be discovered.
• The electromyogram allows measuring the level of involvement in the compressed area.

Arthrodesis is the traditionally herniated disc surgery for cervical disc herniations. This technique allows segments to be fixed in the cervical spine, which causes loss of mobility and new hernias, and cervical osteoarthritis in the short and medium term. Likewise, recovery is slow, requires immobilization and, on many occasions, the results are not favorable to the patient.

Doctor Elgeadi's team avoids the complications of arthrodesis by performing an arthroplasty or cervical disc prosthesis. In this way, the physiological movement of the cervical spine is not affected.

This herniated disc operation consists of the removal of the disc and the hernia that compresses the nerve root and/or spinal cord to replace it with a disc prosthesis. One of the main objectives is to avoid limitations in the movement of the neck after surgery.

It is a minimally invasive technique that only requires an approach of approximately 2 cm into the neck following the marks of the cervical flexure.

The patient is discharged 24 hours after the intervention and does not require any immobilization with a collar. Also, you will be able to move your neck from the awakening from anesthesia without restrictions.

In short, arthroplasty or cervical prosthesis is the most effective, least aggressive, and most beneficial surgical technique for patients with cervical disc herniation at one or more levels, since it is possible to strengthen their cervical.

Doctor Ghassan Elgeadi's team has specialists in cervical disc herniation in Madrid. Thanks to the innovative techniques they use, they allow the patient to experience a rapid recovery and be able to carry out their daily activities.

Traumatologists specializing in cervical disc herniation in Madrid, carry out surgical interventions of the intervertebral disc by arthroplasty. A minimally invasive surgery, allows patients with this pathology to recover their quality of life.