Cervical disc herniation is a condition that occurs when the cartilaginous disc between the cervical vertebrae herniates outward and puts pressure on the spinal cord and nerves going to the arm. Cervical disc herniation is anatomically different from lumbar disc herniation. In the neck, at the level of the hernia, there are both nerves going to the arm and the spinal cord. For this reason, the spinal cord itself may be subjected to pressure.
How is cervical disc herniation treated?
Drugs;
Most cases of cervical disc herniation can be resolved with simple medication and rest treatment. Large hernias, and especially hernias that put pressure on the spinal cord and nerve roots, are usually very painful and require some special treatments. Neuropathic pain medications are used, especially in the presence of severe pain in the arm. In cases of loss of strength in the arm, it may be necessary to use cortisone. Sometimes, when the pain is unbearable despite all the medications, even green or red prescription medications can be used.
Physical therapy;
The final treatment of cervical hernias. It is a highly effective treatment. In physical therapy, treatment agents such as radiation, laser, ultrasound, electrical currents, heat application, massage and traction are used in combination. Most cases improve with these treatments, which do not have any side effects. Generally, 15 sessions are sufficient. Treatment sessions may be extended depending on the situation.
Manipulation,
Means manual treatment and involves more traction maneuvers on the neck. makes. Manipulation should be done by doctors trained in this field. Otherwise, it may make the patient worse and cause more serious undesirable consequences.
Neck brace;
Neck brace for patients whose neck movements are very painful. It may be necessary, but neck braces should be used for a short period of time as they will cause muscle laziness in the long term. It is not necessary to wear the neck collar at night.
Ozone Injection;
Although it is not as common as lumbar hernias, ozone injection can be used in cervical hernias, especially in resistant cases. we are using. A small amount of ozone-oxygen mixture is injected into the side muscles of the neck 5-10 times at intervals of a few days. Even if it causes short-term pain, it is It is extremely effective in shrinking the lump and relieving pain.
Cortisone injection into the neck;
It is a method to be used when other treatment alternatives are exhausted. It is performed on areas under pressure under scopy control under operating room conditions. Although it is a method that works in 50 percent of cases, it should be applied by expert hands.
Patient education;
It is a must for all treatment protocols. In order for the treatments applied to be effective and to prevent the recurrence of healed hernias, the patient should be taught the conditions that he should pay attention to. Patients should avoid situations that require excessive head tilt (long-term computer use, excessive use of mobile phones, etc.). One should use a quality orthopedic pillow and should not sleep with an improper neck position in front of the TV in places such as sofas or sofas. It is important to avoid the cold air conditioner when sweaty and for women not to sleep with wet hair.
Surgery;
Surgery should always be a last resort for cervical disc hernias. Cervical hernias have a high healing capacity. When cervical disc herniations press on the nerves going to the arm and cause severe pain, patients may consider surgery to get rid of the pain. The short-term success of neck surgeries is higher than back surgeries. The reason for this is that cervical disc hernia surgeries can be performed by entering from the front part of the neck, away from the areas where the nerves pass. However, it has been observed that new hernias appear at the upper and lower levels in the long term as a result of gluing the mobile cervical vertebrae together. In cases of cervical disc herniation, surgery should be performed especially when the spinal cord itself is under excessive pressure and there is a risk of myelopathy (permanent damage to the spinal cord). In order to understand the degree of spinal cord pressure more clearly, MEP (motor evoked potentials) test should be performed in addition to MRI. In this way, it is clearer whether spinal cord pressure causes damage to the nerves. In critical patients, monitoring with MRI and MEP may be required.
In summary, the majority of patients with cervical disc herniation can be treated with non-surgical methods, which we call conservative. is treated with spite. The decision for surgery should not be made based on the severity of pain. Other treatment alternatives must be exhausted before deciding on surgery. In rare cases, especially in elderly patients, if there is a risk of permanent spinal cord damage (myelopathy), surgery may be required even if the patient does not have many complaints.
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