What are the symptoms and treatment methods of cervical disc hernia?

By | 3 March 2021

İf you spend long hours at the desk, in front of the computer; If you do not do sports or your muscles are genetically weak, you are in the risk group for “Neck Hernia”. Neck hernia, which can occur as a result of working in front of the computer for hours and inactivity, affects the quality of life of many people. However, new methods in neurosurgery help to increase the quality of life by shortening the diagnosis and treatment processes.

WHAT IS NECK HERNIA?

In addition to resisting body weight and external forces acting vertically, the spine also has to carry out the movement function. Therefore, it should have two conflicting qualities, such as staying still and being mobile. This dual feature is provided by the segmented structure of the spine and the discs between the vertebrae. The discs absorb the forces applied in the vertical direction during tilting and rotation. The posture of human beings on two legs also increases the forces reflected on the disc. As a result, the discs between the vertebrae wear out with age. Their ability to absorb loads and endurance decreases, a herniation may develop. Although the neck does not carry much weight, there is a high risk of deterioration and disc herniation due to its mobile structure. Each vertebra in the neck region spreads to the arm and back in the nerves that come out of the body’s alignment, providing the sensation and movement of these regions. A cervical hernia occurs as a result of the gelatinous inner part of the disc tissue between the vertebrae tearing the outer part consisting of a stronger connective tissue and compressing the spinal cord and nerves.

What are the symptoms of the herniated neck?

Cervical hernia, affecting the spinal cord and nerve roots, is the most common disease in the 30-the 40s of life. Symptoms of cervical disc hernia vary depending on the duration and severity of the disease instead of the hernia. The most common symptoms of neck hernia are as follows;

  • Unilateral pain radiating to the arm,
  • Pain that spreads to the fingertips and is accompanied by numbness.
  • Loss of strength in the arm spreads with pain.
  • Dropping objects under consideration
  • Difficulty walking and instability

Neck hernia can be divided into two periods as acute and chronic. In the acute period: while the herniation of the nucleus pulposus or the free protrusion is in question, in the chronic period, there is a picture called cervical spondylosis with the formation of beaking in the bone (osteophyte) or the widespread degeneration of the structures that make up the spine system in general. In acute neck disc herniations; Unilateral pain can be felt, radiating to the shoulder blade, chest, and upper extremity. The pain may increase with coughing, straining, and sneezing.

If the pain and drowsiness become more frequent and do not pass with bed rest for a certain period of time, a neurosurgeon should be consulted.

WHAT ARE THE CAUSES OF NECK HERNIA?

Although the formation of a cervical hernia depends on many reasons, the deformations in the neck may begin at an earlier age because the neck is more delicate than the waist. Continuously looking at the same point, keeping the neck in the same spot for a long time, spending a long time in front of the computer or television, being exposed to cold air conditioning temperature, and not exercising are among the main causes of neck hernia.

Neck hernia may also occur in some people depending on structural features. Generally, in people with thin, slender, and long necks, a neck hernia is more common in people with short necks. The muscular structures of these people are weaker and are much more easily affected by environmental factors and lifestyle. If there is also bad use of the neck, these people are at a higher risk of cervical hernias. In people with a short neck and a flattened head, the incidence of neck hernia is much lower.

Smoking is also among the reasons that increase the risk of cervical hernias. Especially in those who start smoking at a young age, the neck structure deteriorates in a very short time. While smoking usually causes lung cancer in a long period such as 20 years, cervical hernia cases are encountered in the first 5 years in smokers. Genetic factors are also effective on cervical disc hernia. If there are cases of neck hernia in the person’s family, the risk of hernia also increases.

Inappropriate working and sleeping positions predispose to the formation of neck hernia. Falling asleep while sitting is an important factor of cervical disc hernia. It is necessary to use a neck pillow for people who are accustomed to this type. Since at least 6-8 hours of sleep is spent at night, orthopedic pillows that support the neck and fill the neck cavity should be used. The time spent in a wrong sleeping position increases the risk of getting a cervical hernia.

Risk factors for cervical disc hernia;

  • To work in professions such as traffic accident, trauma, driver, banking,
  • Wrong movements and wrong positions of the neck,
  • Weakness in neck muscles,
  • Wrong posture, psychological stress, fatigue
  • Prolonged computer use
  • Non-professional massage
  • Activities such as housework, sewing, embroidery, cleaning, curtain hanging, and wiping are factors that increase neck pain. Therefore, the incidence of neck pain is higher in women.

HOW IS NECK HERNIA DIAGNOSED?

The detailed history of the patient and physical examination are of great importance in the diagnosis of cervical disc hernia, and it is even possible to diagnose with these. However, it is necessary to confirm the presence of neck hernia and to determine its level with imaging techniques. Detailed neurological examination, appropriate radiological examinations, and nerve electros examination (EMG), and Neck MRI are sufficient to make the definitive diagnosis of cervical disc hernia.

If there are no signs of nerve damage with the examination, the patient is recommended absolute bed rest, use of painkillers, and physical therapy. However, in the presence of signs of nerve damage and other treatment methods fail, surgery is performed.

HOW IS NECK HERNIA TREATED?

If the disease is mild, rest, stress-free life, pain medications, and physical therapy are used for cervical disc hernia treatment. However, if the neck and arm pain does not go away despite medication and physical therapy, if the patients have numbness and weakness in their arms, the patient may need to be treated surgically. Nowadays, neck hernia surgeries can be performed more successfully. It is possible to treat cervical disc hernias with the microsurgical method, which can prevent sleep and reduce the quality of life. With the microsurgery method, the existing complaints of the patient are tried to be eliminated and the quality of life that has decreased due to pain is tried to be increased.

Purpose of neck hernia surgery; While relieving the compression of the spinal cord and the nerves that come out of it, it is to protect many anatomical structures and the function of the neck spine to bear and move. Traditional surgical methods cause normal tissue damage in large areas. Thus, while the spinal cord and nerve tissue are relaxed, it causes the function of the spine to deteriorate. As a result, it may be necessary to perform surgery with materials such as cages, plates, screws in addition to the patient. In this surgical technique that immobilizes the part of the spine at the level of the hernia; The disadvantages of these methods are their long duration, excessive blood loss, and painful and long post-operative recovery period, high rate of failure, and long-term herniation of other discs. On the other hand, the disc prosthesis developed to protect the moving part could not achieve the desired results. It is observed that prostheses lose their mobility in the long term.

Advances in radiological imaging methods (MRI) are useful in the detailed detection of soft and bony tissues that cause cervical disc hernia. In the microsurgery method, a 1.5 cm skin incision is made. Spinal cord and nerve tissues are relaxed by entering the disc distance using natural tissue plans. Since the weight-bearing and mobility of the spine are not impaired, the patient is walked and discharged the day after surgery. The patient does not need to use a neck collar. There is no suture and the dressing can be removed and a bath can be done 2 days after the procedure. After the operation, the patient can sit, walk and go up and downstairs. The exercise program is started 2 weeks after the operation. The results obtained in this “minimally invasive surgery”, ie, neck hernia surgeries with the invasive method, are extremely pleasing. This surgery technique is compared to other surgical techniques that patients are very afraid of; It is especially recommended because of the absence of bleeding, the opportunity to return to social life in a very short time, and the comfort of the operation.

FREQUENTLY ASKED QUESTIONS ABOUT HERNALNECK

What should be considered after neck surgery?

The surgical recovery rate of cervical disc hernia has increased considerably in recent years. If the patient does not benefit from medical treatment and is at risk of paralysis, surgical intervention is performed. After surgical intervention, the rate of recurrence of neck hernia from the same point is extremely low. Operations are no longer performed with very large incisions, microscopic and endoscopic methods are performed by entering the right side of the neck, and after 1-1.5 hours of operations, the patient returns to his normal life within 10 days.

Patients with neck hernia surgery should be able to return to normal activities after 10 days and pay attention to some points. These;

  • In the first seven days after discharge, bed rest should be continued as in the hospital.
  • You should get up only 6-7 times a day (for toilet and food needs) and sleep outside. Care should be taken to ensure that the movements of getting out of bed and lying on the bed are taught.
  • Bed and sleeping style: The bed should be an orthopedic thousand bed suitable for the patient. It can be turned over and/or lying on its back and/or side. An orthopedic pillow should be used. It is essential to first sit and then stand up with support from the arm as taught when getting out of bed.
  • Sitting: After the second week, you can sit upright. Do not sit on low, soft seats or sofas.
  • Toilet: In the first week, the need for a toilet should be met by sitting on the toilet.
  • Bath: There is no harm in taking a bath as the wound line is closed waterproof on the 1st day after discharge from the hospital. Although the wound is left open after seeing the doctor in the 1st week, the patient can take a bath.
  • Walking: One week after discharge, it should be increased every day.
  • Surgery site: There may be tingling, numbness or stiffness at the operation site. It is not possible to open the stitches with movement or coughing. Sutures will not be removed from the wound site. If there is any discharge from the wound site, a doctor should be consulted as soon as possible.
  • Smoking and alcohol: Substances harmful to health should not be used. These are effective in the formation of hernias. It also has a negative effect such as delayed wound healing.
  • Sexual life: Care should be taken to limit sexual activity for a week.
  • Driving: After the first week, you can drive short distances.
  • Diet: Not gaining weight is essential for both the spine and general health. For this reason, if the diet regimen suitable for the patient’s condition needs to be programmed before leaving the hospital, help should be sought from the diet department.
  • Drugs: Drugs given to the patient during his discharge should be used for a period of 1 week.

What are the things to be considered for neck health?

The rules and exercises required to be followed during the day are important for the protection of neck health.

  • The person, object, or object being looked at should be turned from the front in such a way that the head-neck and body are on the same plane.
  • Staying in the same position for a long time should be avoided. Sitting and standing time should not exceed 45 minutes. It should not be neglected to change positions every 45 minutes.
  • Lying on your side should be preferred instead of lying face down. It is important to use orthopedic pillows. Pillows made of feather fibers are not suitable for neck health.
  • It is not suitable for neck health to bend the neck forward while reading. In long-term reading, reading should be done not by bending the neck, but by adjusting the height of the book at an appropriate level and by eye movements. For this, it is useful to use angled book supports.
  • Especially when using a computer, the screen should be at eye level and the screen should be viewed from the body.
  • The neck should be protected from wind, cold, and air conditioning currents that directly hit the neck. Care should be taken not to stay wet after bathing and swimming.

What are the exercises that are good for cervical hernias?

To prevent cervical hernias, it is useful to do exercises that are good for cervical disc hernias regularly. Especially if you are in the risk group of cervical disc hernia, regular exercise should be a part of your life. Generally, exercises that strengthen the neck muscle without bending the neck left and right reduce the risk of getting a neck hernia. The hand is called isometric; Exercises that are pushed by placing the middle of the forehead, temple, and neck and counted up to 10 in each push strengthen the neck muscles. These recommended movements should be done at least 2 or 3 times a day and become a lifestyle. The person can be protected from the risk of neck hernia by taking 5 minutes to himself during the day. Besides; Those who are at risk of cervical hernias can reduce this risk by swimming consciously and regularly. Swimming is an important factor that prevents the deterioration of the neck structure. People working at the desk should use chairs with back and lumbar support. Avoid air conditioners as much as possible and keep computers at eye level.