Hernia Of The Cervical Spine - Symptoms, Causes And Treatment

2024 Author: Josephine Shorter | [email protected]. Last modified: 2024-01-07 17:49

Hernia of the cervical spine: symptoms and treatment

A hernia of the cervical spine is a violation of the integrity of the annulus fibrosus and protrusion of a certain part of the nucleus pulposus beyond the boundaries of the disc, occurring at the level of one or more of the 7 vertebrae of the neck. As a result of this process, the spinal cord and blood vessels are compressed.

According to statistics, a hernia in this spine is not as common as at the lumbar level. This cervical pathology accounts for only 8% of diagnoses of "intervertebral hernia".

Nevertheless, this disease is very dangerous and must be treated without fail. Most often, a hernia is diagnosed in the working-age population aged 30 to 40 years. The overwhelming majority of these people have been or continue to engage in hard physical labor or professional sports. Of 100 thousand people, a hernia will be detected in 50, moreover, most of the sick are men. Mostly, a hernia is found at the level of C6C7 segments or C5C6 segments.

Schmorl's hernia is a formation that is often found in the cervical spine. Pathology got its name from the German scientist and physician Christian Schmorl, who first described it. It differs in its location, does not affect the neurovascular bundles, does not compress the spinal cord, as a result of which the clinical symptoms of a hernia of the spine are rather scarce. Childhood and adolescence is the time when Schmorl's hernia is usually found.

Content:

• Symptoms of a hernia of the cervical spine
• Causes of a hernia of the cervical spine
• Possible complications
• Treatment of a hernia of the cervical spine
• Surgical treatment of cervical hernia

Symptoms of a hernia of the cervical spine

In order for the hernia to be diagnosed on time, it is necessary to know the symptoms of the disease, which are represented by the following clinical picture:

• Sudden, sharp pain in the shoulders, neck and head. Attempts to move your shoulders or turn your head lead to increased symptoms;

• The early symptoms of a hernia may be mild. Pain occurs at regular intervals. The person suffers from migraines, numbness in the fingers, sore throat and dry cough. Misdiagnosis is often made, such as hypertension or neurological disorders. At the same time, the hernia remains undetected and continues to grow;
• Severe limitation of mobility of the cervical spine;
• The onset of dizziness, tinnitus, darkness in the eyes. Sometimes the patient may even lose consciousness for a short time. This is due to the fact that the hernia squeezes the nerve endings located in the immediate vicinity of it. As a result, there is a violation of the innervation of those areas of the body that relate to them. As a result - oxygen starvation of the brain;
• Symptoms of a cervical spine hernia can vary depending on which segment the hernia is located in. If these are the fourth and fifth vertebrae, then the pain will be localized in the forearm muscles. In this case, numbness of the hands is not observed. The unpleasant sensations intensify when a person tries to raise the upper limbs above the head;

• When the disc located between the sixth and seventh vertebrae becomes the site of localization of the hernia, the patient feels muscle weakness in the forearm, in the triceps and in the big toe of the upper limb. In this case, the seventh cervical nerve is subjected to compression. Often, patients report running "goose bumps";
• When a hernia forms between the first thoracic vertebra and the seventh cervical vertebra, the patient suffers from pain in the little finger and hand. In addition, the entire upper limb is weak and numb;
• Radicular syndrome, which manifests itself as the disease progresses. The pains become more intense, begin to radiate to the shoulder blades, shoulders, the back of the head. The skin located in the immediate vicinity of the damaged area loses its sensitivity. In the absence of adequate therapy, atrophy of the muscular component of the cervical spine occurs. The disease progresses and is more difficult to treat.

It should be understood that the symptoms may differ in each case and largely depend on the direction in which the hernia protrudes (anterior, posterior, lateral). For the most part, this affects the severity of somatic symptoms.

Causes of a hernia of the cervical spine

There are several reasons leading to the development of the disease, among them:

• Spinal injuries leading to disruption of the integrity of the annulus fibrosus and protrusion of the nucleus outward. Often unsuccessful dives, falls, illiterate gymnastic exercises lead to the formation of a hernia;
• Poor posture. Its violations contribute to the fact that the muscles are constantly in an increased tone, experience additional stress, which contributes to the disruption of the biomechanics of the spine;
• Lifting weights;
• Sedentary lifestyle;
• Natural aging process of bone and cartilage tissue of the spine. It starts after 25 years, when the spine is completely ossified. The amortization of the annulus fibrosus decreases, the structure of the nucleus pulposus is destroyed, tears can form even with minor loads;
• Osteochondrosis;
• Genetic predisposition. Degenerative processes are accelerated if the next of kin suffered from similar problems;
• Work in production associated with heavy physical activity. Continuous daily driving and computer work is a potential threat;
• Overweight;
• Bad habits and poor lifestyle in general;
• Rheumatoid diseases.

Possible complications

If a hernia is left unattended for a long time, it threatens with serious consequences:

• Disorder of hand movements, up to paresis or paralysis, impaired sensitivity of the skin of the fingertips, forearm, hand;
• If the spinal cord is pinched, the patient must be taken to the hospital as soon as possible, as this threatens to stop breathing;
• A pronounced curvature of the spine, which is visible with the naked eye, is another complication of the disease;
• In addition, a person becomes irritable, his mood often changes, problems with hearing, vision, coordination may occur, nausea, vomiting, loss of consciousness is observed;
• Violation of cerebral circulation causes early strokes.

Moreover, the more the hernia protrudes into the spinal column, the more serious the consequences of the disease will be. In this case, only conservative treatment will not be possible, and it will be necessary to resort to surgical intervention.

Treatment of a hernia of the cervical spine

It is impossible to start treating a hernia of the cervical spine without preliminary diagnostics, which will reveal the presence or absence of a hernia. The main method used in modern medicine is MRI. The study will allow the doctor to get a complete picture of what is happening in the cervical spine, give information about the size of the protrusion and the associated inflammatory processes. Only after undergoing an MRI will it be possible to prescribe a treatment adequate to each specific case.

Doctors note that drug treatment is aimed only at reducing the severity of the symptoms of the disease. It is impossible to completely get rid of a hernia of the cervical spine with conservative methods. Medicines are used only as adjuvant therapy.

Most often, for the treatment of a hernia of the cervical spine, the patient is prescribed:

• Non-steroidal anti-inflammatory drugs. They help reduce pain, help relieve stiffness in the limbs, reduce swelling, which allows you to expand the patient's range of motion. The most popular are: diclofenac, aspirin, ibuprofen, rheumoxicam, indomethacin, ketoprofen, movalis, etc. However, their long-term use threatens that the patient may develop a stomach ulcer. Therefore, to relieve muscle spasm, the patient is prescribed muscle relaxants. When pain is not relieved by oral medication, a steroid injection into the hernia may be done. It can only be done by a doctor using a special needle;
• The drugs from the group of muscle relaxants include methocarbamol, carisoprodol, cyclobenzaprine, drotaverine, etc.;
• Cervical applications with the use of Dimexide, novocaine and ketoprofen help relieve pain;
• Baclofen, sirdalud, miolastan will help to reduce muscle tension and relieve spasm;
• To cope with neurological disorders somewhat, to improve the sensitivity of the affected area, intramuscular administration of vitamins B, E, C will help;
• It is possible to speed up the process of tissue repair, slow down the degeneration of cartilage through the use of chondroprotectors. For this purpose, glucosamine, chondroitin sulfate are prescribed.

In addition to drug treatment, there are other conservative methods of therapeutic action:

• Horizontal or vertical traction of the spine, which reduces the pressure of the hernia on the nerve roots, reducing swelling, relieving inflammation and pain;
• Reflexology, which is carried out by introducing needles into the most biologically active points of the cervical spine. The method is aimed at achieving a regenerative and sedative effect;
• Hirudotherapy helps to eliminate swelling and pain, to normalize blood pressure;
• Electrophoresis with pain medications;
• Vacuum therapy aimed at relieving pain, improving the microcirculation of fluids in the cervical spine;
• Manual therapy and magnetopuncture;
• Performing a set of exercises for medical gymnastics.

In addition, the patient needs to limit the load on the cervical spine as much as possible, wear a special cervical collar. Sometimes bed rest is prescribed and the person is removed from work.

On the subject: The use of chondroprotectors for hernia - a list of drugs, are they effective at all?

Surgical treatment of cervical hernia

When none of the methods of conservative treatment has the desired effect, and a hernia of the cervical spine compresses the nerve endings and interferes with the normal blood supply to the brain, surgery is necessary.

Among the indications for the operation:

• Lack of effect from therapy for six months;
• Progressive weakening of the muscle corset;
• Sequestered hernia of the cervical spine with detachment of cartilage tissue;
• Severe pain syndrome, not relieved by drugs.

The decision about the impossibility of doing without surgery is made by several doctors based on the diagnostic data obtained. Discectomy is considered a traditional method of hernia surgery. The bottom line is to remove the disc and replace it with an implant. Sometimes, when it is not possible to get close to the hernia from the side of the spine, an anterior discectomy is performed with fusion (fusion of the vertebrae) or without fusion. That is, the incision is made from the side of the front surface of the neck, the hernia is removed, and the remaining space in the first case is filled with a soldering compound, and in the second case, the vertebrae are allowed to grow together on their own.

The decision on whether to use spinal fusion or not remains controversial. Some surgeons argue that this will ensure immobility of the distraction in the area of intervention, which means it will prevent the collapse of the intervertebral foramen. An argument against spodilodesis is the fact that the degree of final distraction is minimal, and disc fusion will still occur, even without graft placement. In addition, due to fusion, the number of complications increases, including postoperative pain.

Discectomy is used by modern doctors only in extreme cases, because the operation is fraught with complications. First, the trachea, blood vessels, esophagus can be damaged. Secondly, removing and pulling off the laryngeal nerve can lead to temporary hoarseness of the patient. Thirdly, spinal fusion may be impaired, and the cervical vertebrae will become unstable, which means that repeated surgery will be required. Fourth, there is always a risk of infection.

Therefore, doctors are increasingly resorting to minimally invasive techniques aimed at removing a hernia. Among them is microdiscectomy, which is performed using a forehead magnifier or using a microscope. This allows you to make a minimal incision of no more than 4 cm, and the operation itself can be carried out in a short time. The patient will be sent home within 24 hours.

See also: All types of hernia surgery - indications and consequences.

Such methods of treating a hernia of the cervical spine as removal of the formation using an endoscope, that is, an endoscopic technique, vaporization of the cervical hernia nucleus, laser puncture, are also popular. Remember that the symptoms of a hernia of the cervical spine seem harmless only in the first stages of the disease, but if this pathology is not treated, then spinal surgery cannot be avoided later.

The author of the article: Volkov Dmitry Sergeevich | c. m. n. surgeon, phlebologist

Education: Moscow State University of Medicine and Dentistry (1996). In 2003 he received a diploma from the Educational and Scientific Medical Center of the Presidential Administration of the Russian Federation.