Hernia de disco cervical

A cervical disc herniation happens when part of a “cushion” between two neck bones tears and bulges out, pressing on nearby nerves or, less often, the spinal cord. This can cause neck pain plus sharp, shooting pain, tingling, or weakness down the shoulder, arm, or hand.​

1) What is this condition?

  • The neck has soft discs between the bones that act like shock absorbers; with wear or injury, the inner gel can push through a tear in the outer ring.​

  • When the disc bulges or breaks out, it can press on a nerve going to the arm (pinched nerve) or, if large and central, on the spinal cord.​

2) How serious is it?

  • Many disc herniations cause pain and tingling but are not life‑threatening and often improve over time.​

  • It becomes more serious if there is significant weakness, trouble with balance, or bladder/bowel changes, which need urgent medical attention.​

3) Non‑surgical treatments

  • Short‑term rest and activity changes: avoiding heavy lifting, overhead work, and positions that worsen arm pain.​

  • Medicines: anti‑inflammatory drugs, pain relievers, sometimes brief use of muscle relaxants or nerve‑pain medicines.​

  • Physical therapy: gentle stretching, posture work, neck and shoulder strengthening, and traction in some cases.​

  • Injections: targeted epidural or nerve‑root steroid injections to reduce inflammation and arm pain in selected patients.​

4) Possible surgery

  • Anterior cervical discectomy and fusion (ACDF): through the front of the neck, the surgeon removes the disc and fuses the two bones together.​

  • Cervical disc replacement (artificial disc): similar front approach, but the disc is replaced with a motion‑preserving device instead of fusing.​

  • Posterior cervical foraminotomy: from the back of the neck, removing bone/soft tissue to free the nerve, sometimes without removing the whole disc or doing a fusion.​

5) Goals of surgery vs non‑surgical care

  • Non‑surgical goals:

    • Reduce pain and tingling, improve daily function, and allow the disc to calm down or shrink over time without an operation.​

  • Surgery goals:

    • Directly remove the pressure on the nerve or cord, relieve arm pain, and prevent or improve weakness and other nerve problems.​

6) How surgery can fix the problem

  • In ACDF, the surgeon removes the herniated disc and any bone spurs, frees the nerve, then places a spacer and often a small plate so the two bones grow together.​

  • In disc replacement, the damaged disc is removed and replaced with an artificial disc that keeps some neck motion at that level.​

  • In posterior foraminotomy, a small “keyhole” of bone and disc is removed from behind to open the tunnel for the nerve.​

7) Risks of surgery (general and specific)

  • General: infection, bleeding, blood clots, and anesthesia‑related heart or lung problems.​

  • Anterior‑specific: trouble swallowing, hoarseness, injury to the food pipe or windpipe, and problems with the graft, plate, or disc implant.​

  • Posterior‑specific: higher odds of wound problems, infection, neck muscle pain, and sometimes a higher re‑operation rate compared with ACDF in some studies.​

8) Chances this surgery will work

  • Most people have good relief of arm pain after surgery; non‑operative programs already help many, but surgery is very effective when symptoms persist.​

  • Cervical disc replacement and ACDF both show high rates of pain relief and function improvement in one‑ to two‑level disease.​

9) Possible complications from the surgery

  • Persistent or recurrent arm pain if the nerve remains irritated or a new herniation or bone spur develops.​

  • After fusion: stress on nearby levels (adjacent‑segment disease) over years, sometimes requiring another surgery.​

  • After disc replacement: device wear, loosening, movement loss, or unwanted bone growth around the implant, occasionally leading to revision surgery.​

10) Typical recovery from the condition (without surgery)

  • Many patients improve over weeks to months with a focused non‑surgical program; one study reported about 90% doing well at one year.​

  • Flare‑ups can occur with certain activities or postures, but strengthening, posture work, and lifestyle changes often keep symptoms manageable.​

11) Typical recovery after surgery

  • Early: arm pain often improves quickly; throat soreness and mild swallowing trouble are common for a few days after front‑of‑neck surgery.​

  • Weeks to months: gradual return to normal activities, with limits on heavy lifting and impact sports while fusion or healing progresses.​

  • Numbness or weakness, if present for a long time before surgery, may improve slowly and may not completely resolve.​

12) How long in the hospital

  • Many one‑level ACDFs, disc replacements, or foraminotomies are outpatient or require only one overnight stay if there are no complications.​

  • Multi‑level surgery or significant medical issues may increase the stay to 2–3 days or more.​

13) Long‑term outlook

  • With good conservative care, many never need surgery and maintain good function with occasional flares.​

  • After successful surgery, long‑term satisfaction and pain relief are generally high, though some stiffness or ongoing mild symptoms are common.​

14) Need for outpatient follow‑up

  • Non‑surgical: regular visits to track pain, strength, and function; adjust therapy and medications; and repeat imaging if symptoms worsen or new red flags appear.​

  • Post‑surgery: scheduled checks for wound healing, nerve recovery, and (for fusion) X‑rays to confirm bone healing and alignment.​

  • Long‑term: ongoing posture and strengthening work, lifestyle changes to protect the neck, and prompt review if new symptoms or levels become involved.