Cervical disc herniation, commonly known as a neck disc herniation, occurs when the soft center of a cervical disc (nucleus pulposus) pushes through its outer ring (annulus fibrosus) and compresses nearby spinal nerves or, rarely, the spinal cord itself.
This condition can cause neck pain, arm pain, and numbness or weakness in the upper limbs.
While many patients improve with conservative therapy, persistent or severe nerve compression may require microsurgical or endoscopic decompression for lasting relief and neurological recovery.
Symptoms
The symptoms depend on which cervical level is affected — most commonly C5–C6 and C6–C7, where nerves travel to the arms and hands.
Common symptoms include:
- Neck pain radiating to the shoulder, arm, or hand
- Numbness or tingling in the fingers or forearm
- Arm weakness (difficulty lifting or gripping objects)
- Pain worsened by neck movement or sneezing
- Loss of reflexes in the arm
- In severe or advanced cases:
Spinal cord compression (myelopathy) — causing gait imbalance, clumsiness in hands, or urinary urgency
These findings indicate progressive nerve compression that requires urgent evaluation.
Diagnosis
MRI of the cervical spine is the gold standard for diagnosing disc herniation and determining nerve or spinal cord compression.
CT scan may be used to assess bone spurs or degenerative changes.
Electromyography (EMG) helps localize the affected nerve root in complex cases.
A thorough neurological examination assesses muscle strength, reflexes, and sensory changes to guide treatment decisions.
Treatment Options
1. Conservative (Non-Surgical) Management
- Short rest and activity modification
- Pain-relieving and anti-inflammatory medications
- Physical therapy and neck stabilization exercises
- Cervical traction and posture correction
- Epidural or selective nerve root injections for persistent pain
Most patients experience significant improvement within 6–8 weeks.
2. Microsurgical Discectomy (Anterior Cervical Discectomy and Fusion – ACDF)
For cases with persistent pain, weakness, or spinal cord compression, microsurgical discectomy through a small anterior (front) incision provides direct decompression of the nerve and spinal cord.
The disc is removed, and the space is reconstructed with a titanium cage or artificial disc, restoring height and stability.
This approach achieves excellent long-term results with minimal tissue disruption.
3. Posterior Keyhole Sequestrectomy
In selected cases — especially when the herniated fragment is lateral or foraminal — a posterior keyhole sequestrectomy can be performed.
Through a small posterior incision, only the herniated fragment (sequestrated disc) is removed under microscopic vision, preserving most of the native disc and spinal motion.
This minimally invasive approach offers rapid recovery, less postoperative pain, and shorter hospital stay.
4. Endoscopic or Motion-Preserving Techniques
In selected patients, endoscopic discectomy or cervical disc replacement (arthroplasty) can relieve compression while preserving natural neck motion.
These techniques offer faster recovery and reduced postoperative stiffness.
Recovery & Follow-Up
Most patients can return home within 24–48 hours after surgery.
Early neck mobilization and gentle stretching are encouraged.
Physical therapy begins within 2–3 weeks to strengthen neck and shoulder muscles.
Full recovery, including nerve function improvement, typically occurs within 4–6 weeks, depending on the degree of preoperative compression.
Follow-up MRI is done when symptoms persist or to assess fusion progress after ACDF.
When to See a Neurosurgeon
If you experience radiating arm pain, hand weakness, numbness, or difficulty walking or balancing, you should seek immediate neurosurgical evaluation.
Early diagnosis prevents permanent spinal cord damage and ensures full recovery of nerve function.