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Herniated discs in the cervical spine

Slipped discs (other designations are disc prolapsed, herniation, nucleus pulposus-Prolapse-) are a result of wear or wear process due to persistent stress. As previously stated conditionally loads (i.e. force or pressure) cause dehydration and thus a loss of elasticity and therefore a brittleness of the disc. If it then comes to a crack in the damaged outer circle, the soft inner core will squeeze itself out.

The most common cervical disc herniation is located between the 5th and 6th and 6th and 7th cervical vertebrae and is found mainly in the rear section of the fiber ring, since there remained small scars from the former vessel supplying the disc and therefore the fiber ring is particularly weak at this location and can tear easily. The tissue that comes out can then lead to an irritation or compression of the spinal cord injury (we call this as myelopathy) or of the spinal nerve roots departing from the spinal cord. Deformities of the cervical spine with a so-called flat back or even kyphosis may also result. This leads to an incorrect loading of the vertebral joints and muscles.

Leading symptoms are radiating pain from the neck into the arm and outgoing, down to the hand; numbness and paralysis may also occur, when there is a very strong pressure of the disc on the nerve roots. For certain nerve roots, there are characteristic muscles, such as C6 syndrome with restriction of arm flexion, C7 syndrome with restriction of arm extension. Emotional disturbances affect certain dermatomes (skin areas), e.g.  C6 -> thumb + index finger, C7-> middle finger, C8 -> ring and little fingers.
Treatment measures are primarily dependent on the type of pain, the neurological deficits and visual-morphological findings, although basically distinguished between conservative (pain medication + physiotherapy + local injection), minimally invasive (fluoroscopic or CT-guided injections -> PRT) and operative therapy (foraminotomy, artificial disc, fusion distinction). The therapy is based on this step diagram. If a form of therapy does not show the desired results within a time window of 3-4 weeks, then it must be “scaled” to the next level.  A long adherence to treatment measures without an improvement leads to chronicity of the complaints with the emergence of pain memory, and to fixation of poor posture because the muscle attachments are reduced, joint capsule are shrinking and disc herniation calcifing.