When is surgery necessary for a herniated disc in the neck?

When is Surgery Necessary for a Herniated Disc in the Neck?

The spine consists of bones called vertebrae, the facet joints behind them, and the disc tissue between them. The disc structure is composed of the annulus fibrosis, a strong and elastic outer layer, and a gelatinous inner formation called the nucleus pulposus, which is 80% water.

How does a neck hernia (cervical disc herniation) occur?

Over time, as a result of aging, the annulus fibrosis wears down and may tear at a certain point. Due to pressure, the gelatinous substance inside protrudes outward. In other words, herniation occurs.

What are the symptoms of a neck hernia?

The herniated disc can lead to different symptoms depending on where it puts pressure:

In case of pressure on the nerves:

  • Pain in the shoulders
  • Weakness in the arms
  • Loss of sensation in the hands and fingers
  • Numbness sensation in the arms and hands

In case of pressure on the spinal cord:

  • Weakness in the legs
  • Difficulty walking or loss of walking ability
  • Disorders in bladder and bowel control (in advanced stages)

Diagnosis Process

We follow these steps while diagnosing our patients:

  1. Detailed history taking:
    • The onset style and timing of the pain
    • Radiation of pain from the neck to the arms
    • Whether any trauma has been experienced
    • Lifestyle and daily postures
  2. Neurological examination:
    • Detailed physical examination
    • Muscle strength assessment
    • Sensory tests
  3. Imaging methods:
    • Neck X-ray
    • Neck MRI (Magnetic Resonance Imaging)

Treatment Options

Non-surgical treatment

Most patients with a neck hernia recover without the need for surgical intervention. Our conservative treatment approach consists of the following stages:

  1. Medical treatment:
  • Painkillers
  • Muscle relaxants
  • Heat application
  • Rest
  1. Physical therapy:
  • Neck exercises
  • Physical therapy modalities
  • Posture correction studies
  1. Epidural steroid injection:
  • Applied to patients whose complaints do not subside with the methods mentioned above.

Surgical Treatment

Surgery may be necessary in the following situations:

  • Presence of pressure on the spinal cord
  • Severe pressure on the nerves
  • Significant weakness in the arms, hands, or fingers
  • Failure to benefit from conservative treatments

Surgical Methods

We perform neck hernia surgeries using two different methods:

Anterior approach (the most commonly used method)

  • Performed through a short incision of 2-3 centimeters
  • Carried out under a microscope
  • The diseased disc between the two vertebrae is emptied
  • A bone graft or disc prosthesis is placed in the emptied space

Posterior approach

  • In very few cases and special situations, intervention is performed from the back of the neck

Post-operative Process

Surgical treatment yields highly beneficial results. The recovery process after surgery proceeds as follows:

  • The patient is mobilized within 2-3 hours after surgery
  • If everything is going well, they are discharged a day later
  • Rapid recovery and return to normalcy are achieved

Possible Complications

As with every surgery, there are some risks, albeit small, in neck hernia surgeries:

  • Infection
  • Bleeding
  • Nerve damage
  • Rarely, spinal cord injury

These complications are seen at very low rates in experienced hands, and the surgery is performed by taking all necessary precautions.

A neck hernia is a condition that can be successfully treated with early diagnosis and the correct treatment approach. If you have complaints, early application increases treatment success. You can contact our clinic for a detailed examination and diagnosis.