The part of our body where disc herniation occurs second most frequently –lumbar area being the first- is the cervical spine, which is there to carry our head and is just as active as lumber area but is subjected to fewer loads. Though much less frequently, disc herniation may also develop in thoracic vertebra, too. Thoracic vertebra is supported by the rib cage which leads to fewer motions between the vertebrae of this region, causing less frequent disc herniations.
What are the symptoms of cervical disc herniation?
In principle, there is pain along the organ corresponding to the nerve compressed by the herniation. Pain is felt along the line from neck to arms. When a patient puts arms over his head, pain alleviates. The elbow feels weaker while moving to push or pull. Hand feels weaker when grasping, turning a key, opening a bottle cap. If a patient with cervical disc herniation has a seriously compressed nerve, he can not sleep due to pain. A patient with cervical disc herniation who can sleep normally does not generally require surgery.
Do all neck pains arise from hernia?
Not all neck pains are due to disc herniation. The most frequent reason for a sudden cervical and lumbar disc herniation is that the cartilage between the facet joints is pushed on the side due to an abnormal sprain. This situation called “locked facet” is confused with cervical disc herniation.
As MR is frequently used today and all patients today have somehow a disc herniation to some extent -though not important-, when radiologists mention such an issue in their reports, then locked facet is mistaken for disc herniation. A lumbar or cervical “locked facet” is opened with a maneuver, however it does not work for disc herniation
Muscle stiffness in the neck is also one of the frequently observed situations. Motions of neck might be restricted due to a muscle that has been exposed to direct wind current or to an air conditioner while body is sweating.
When is surgery required in cervical disc herniation?
Not all cervical disc herniation requires surgery. Because the neck carries head, disc herniation in this region responds positively to bedrest. Surgery may be required for those who have not improved even after 15 days of intensive bed rest. If there is serious loss of strength in arm and pain prevents patient from sleeping, surgery might be performed even earlier.
Patients whose pains fade away by resting should not be subjected to an operation. These patients are given a protective gymnastics program.
Dr. Yunus Aydın’s surgery technique for cervical disc herniation
In our country, when a doctor recommends surgery to patients, patients start visiting other doctors. As they visit more doctors, they feel more confused. In addition to the brain surgeons, they also visit physiotherapists or orthopedists, in which case the confusion increases even more.
I, as Dr. Yunus Aydın, have used my technique, called “contralateral simple microdischectomy” for over 20 years. For the last 10 years, I have applied “fat graft, which is obtained under patient’s skin, to the gap that forms after clearing the herniation. By using this technique, we aim the following:
- Surgery scar forms on the opposite side of the arm in pain, which better reveals the herniated piece, also allowing the reach to the herniation with less incision.
- Cartilages between joints are protected. A disc which has not been damaged and is waiting aside should not be over-emptied. Bone tissue is protected, which helps the distance that has undergone surgery to avoid any collapse and any shape deformation later on.
- The piece of fat placed in between prevents bones from fusing one another, which causes loss of the motion of joints.
- With this technique, patients can do any movements 3 hours after surgery and can go home 5 hours after surgery if they desire, and they can go back to work earlier and return to normal life 2 weeks after surgery.
- It will not lead to an “adjacent segment disease” unlike other techniques which would remove the motions of joints; in other words, there is not any new disc formation or calcification.
- It produces more comfortable and aesthetic results.
- It is advantageous in that it helps patients return to work earlier.