Cervical Disc Herniation
What you need to know
A common problem that can produce pain, numbness or weakness down the arm to the fingers. The disc is the material between the two bones that acts as a cushion and shock absorber which also allows for neck motion. Sometimes the discs weaken and wear out. A tear can be produced in the periphery of the disc (annulus) which allows for the material within the disc to rupture and squeeze out. This material can then put pressure on the nerves and the spinal cord, which can lead to arm pain.
The nerves in the neck also control muscle strength and sensation and in severe cases, the herniation will lead to numbness and weakness of the arm. The imaging test of choice is a MRI which can directly assess the location and severity of the herniation within the spinal canal.
Most patients do not need urgent surgery and try numerous non operative treatments to resolve the pain. These include anti-inflammatories, nerve pain pills, muscle relaxants, rest and physical therapy. If these options fail, an epidural steroid injection can be performed to provide relief.
If conservative treatments fail, there are several surgical solutions that can be performed. These include removal of the disc herniation to take the pressure of the nerves and spinal cord, which is commonly either a fusion procedure or a disc replacement.
Cervical Spine Fusion
Anterior Cervical Discectomy and Fusion (ACDF)
Patrick J. Horan, MD, MBA, FACS
Patrick J. Horan is an orthopaedic surgeon and sports medicine specialist with two decades of experience. He is board-certified in orthopaedic surgery and sports medicine. After receiving his undergraduate degree from Duke University in Durham, N.C., Dr. Horan earned his medical degree from Tufts University School of Medicine in Boston. Residency and Internship were both completed at Walter Reed Army Medical Center in Washington, D.C. He also received an MBA from Auburn University in Auburn, Ala.
Dr. Horan served 10 years on active duty in the US Army as an orthopaedic surgeon before entering into private practice. Dr. Horan is the founder of the Westchase Orthopaedic and Rehabilitation and the official surgeon of the Tampa Bay Rowdies. He maintains professional memberships with the American Academy of Orthopaedic Surgeons, the American Academy of Orthopaedic Sports Medicine and the Arthroscopy Association of North America.
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