2023-08-21 21:12:19
Definition: what is a cervical hernia?
The hernie cervicale corresponds to a particular form of herniated disc, occurring at the level of the neck. As a reminder, a herniated disc is a protrusion (or small bump) at the level of the portion of an intervertebral disc, compressing a nerve root or the spinal cord. This compression is the cause of the pain. In case of cervical hernia, it is a protrusion of the nucleus pulposus (or nucleus pulposus) in the fibrous tissue of the cervical intervertebral discs.
Cervical disc herniation is a common condition. Its prevalence increases with age. It occurs more frequently in women after menopause.
When symptomatic, cervical hernia causes cervico brachial neuralgiaa neurological pain that starts from the neck running through the arm to end at the level of the fingers of the hand.
Cervical disc herniation may be related tocervical spondylosis or have a traumatic origin.
The diagnosis of cervical disc herniation is confirmed by MRI examination.
Management most often combines measures aimed at relieving pain and rehabilitation. Sometimes, surgery is nevertheless necessary to overcome the cervical hernia.
Causes: what causes a cervical hernia?
There are two main possible causes of cervical disc herniation:
- And trauma (road accident with whiplash, fall, false movement, etc.). We then speak of soft cervical hernia. This type of hernia concerns more the young and healthy subject.
- A cervical spondylosis. As a reminder, osteoarthritis corresponds to a progressive degeneration of the cartilage. We speak in this case of hernia hard cervical. This form of hernia develops more in the elderly.
It is worth noting that sometimes the cervical hernia develops for no particular reason. We are talking about the idiopathic form.
Of the family historythe smoking or even the repeated carrying of heavy loads are factors that promote the onset of the disease.
What are the symptoms of a herniated disc?
Cervical disc herniation is sometimes silent, causing no symptoms.
- Nevertheless, cervical disc herniation can cause cervico brachial neuralgia. It is a neurological pain that starts from the neck and spreads along the arm to the fingertips of the hand. The pain is often intense preventing some patients from sleeping at night. It can be increased by rotational movements of the head. There is no antalgic position to relieve pain;
- The pain is sometimes associated with a difficulty moving head and at one neck stiffness ;
- Of the sensory disorders in the affected arm are also described by patients. It can be tingling (paresthesias) or a decreased sensitivity (hypoesthésie) ;
- Headaches (headaches) are possible.
This pain is likely to affect the quality of life of patients.
Is a cervical hernia serious?
Cervical disc herniation is sometimes more serious in the event of compression of the nerve roots intended for the lower limbs (pelvis and legs). It then causes certain signs of gravity such as:
- of the difficulty walking ;
- of the urinary disorders ;
- a clumsiness of the hands ;
- a feeling of decreased hand strength… .
In this case we are talking about cervico-osteoarthritis myelopathy. Since irreversible lesions are frequent and disabling, emergency surgery is generally proposed.
How to diagnose a herniated cervical disc?
L’physical examination of the physician guides the diagnosis. Of the x-rays first allow to observe a possible cervical osteoarthritis or a narrowing of the intervertebral discs. The diagnosis will be confirmed by Magnetic Resonance Imaging (MRI) of the cervical area which will show the protrusion discale. Other complementary examinations may be prescribed such as a electro-myogram.
Can a cervical hernia be cured?
In nearly 9 out of 10 cases, a soft cervical disc herniation (that is to say of traumatic origin) will resolve spontaneously. The disc protrusion causing the compression will resolve on its own. Nevertheless, if the pain persists after 3 months, a surgical solution can be considered by the doctor.
On the other hand, a hard cervical disc herniation (due to osteoarthritis) does not resolve on its own. It would even tend to worsen over time with the progression of cartilage degeneration and the formation of parrot beaks (osteophytes). When medical treatments are no longer sufficient to relieve painful attacks, surgery is usually proposed by the doctor.
How to relieve a herniated disc (and neck pain)?
Rest and painkillers can relieve pain and other symptoms. It could be :
- d’painkillers (paracetamol) and D’anti-inflammatories (codeine, ketoprofen and corticosteroids). More rarely, morphine is administered;
- of the infiltrations spinal cortisone;
- a immobilization by a neck brace;
- of physiotherapy (muscle strengthening, massages…).
The practice of sports activities in times of painful crises is strongly discouraged.
When to operate a cervical hernia?
A intervention chirurgicale can be discussed in case of aggravation or persistence of symptoms despite medical treatment. It aims to decompress nerve structures removing the disk fragment. This procedure involves making a small incision on the front and side of the neck. Once the hernia has been removed with the disc, the space between the two vertebrae cannot be left empty and this must be replaced by a cervical prosthesis or a arthrodesis cage (the two adjacent vertebrae are fused).
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