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Hernia of the cervical spine: symptoms and types of treatment

Before proceeding to the consideration of the problem, I would like to draw the attention of the respected Internet community to the correctness of pronouncing medical terms.

On the net one can read “intervertebral hernia of the cervical spine” quite often - this is a completely illiterate expression, it means “hernia between the spines”. To do this, you need at least two people, fused backs. This also includes "medicine" medications.

The correct term is intervertebral hernia, which indicates that there is destruction and protrusion of the intervertebral disc. Talking about a “intervertebral” hernia is the same as going to the library to hand over a “lost” book.

Therefore, if you find a site with the same name, it is better to leave it. Otherwise, the advice you decide to follow can be expensive, and not so much for your wallet as for health.

What is intervertebral hernia localized in the cervical region, how is it manifested and how is it treated?

Content

Hernia in the cervical spine - what is it?

Hernia in the cervical spine

photo scheme

Intervertebral hernia of any part of the spine is called the destruction of the fibrous ring or the gelatinous nucleus of the cartilaginous intervertebral disk, in which these structures extend beyond the contour, forming a protrusion in different directions (sideways, forward, backward, up).

And the names of the hernias are different: paramedian, lateral, foral. The most dangerous hernias that are bulged in the posterior direction, as they can cause compression of the spinal cord (see photo).

Hernia in the cervical spine develops due to the following conditions:

  • Injury. This may be a head kick on a low doorway, slipping on ice in winter, or a consequence of carrying heavy loads on the head, a sudden movement or rotation of the neck, and extreme sports;
  • The age of the patient. A gradual decrease in the elasticity of the discs due to their dehydration can lead to their increased brittleness. Otherwise, this cause is called “ cervical osteochondrosis ”;
  • Osteoporosis. Violation of the articular surface of the vertebral bodies leads to the destruction of the cartilage that lies between them. Often this occurs in postmenopausal women;
  • Bad habits, especially smoking. Without directly leading to a hernia, smoking causes impaired blood circulation and diffuse feeding of cartilage, leading to disc fragility;
  • Overweight. More often, it causes hernia formation in the lumbar region, and in the cervical region it is caused by wearing heavy winter hats and hairstyles;
  • Weakness of the neck muscular corset. Office work leads to this, lack of exercise. Initially, the "instability" of the cervical region develops, and then the destruction of cartilage occurs with the formation of single or multiple hernias.

Symptoms of a hernia of the cervical spine

Symptoms of a hernia of the cervical spine

In this lesion of the musculoskeletal system of the spine, there are general symptoms that can occur with any localization of the lesion, and specific signs that depend on the specific location of the hernia.

It is for the symptoms of the second type that an experienced neurologist will be able to make a preliminary diagnosis with a high degree of probability, even without resorting to such diagnostic methods as MRI.

Common symptoms

First of all, it is a different pain in the neck with a hernia. Their localization may be different. The nature of the pain is pulling, constant due to chronic muscle spasm, which got into the zone of innervation by those nerves that the hernia squeezed.

In this case, the neck muscles are in a state of chronic stress. There is a "vicious circle". The pain intensifies the muscle fiber spasm, the spasm interferes with its normal nutrition, blood circulation and abstraction of waste products. In turn, the accumulation of lactic acid in the muscle causes its secondary spasm.

These neck pains can irradiate to the back of the head, the parieto-temporal areas, and cause vertebral cervicocranialgia.

The second type of pain is a sharp, shooting, similar to an electric shock, just like a lumbar "chamber". It has a neurological nature, and is not associated with muscular pain, but with a feeling born within the nerve fiber itself. The second name is radicular symptoms.

These sharp pains, if the patient has a neck hernia, can be provoked by the following factors:

  • A sharp turn of the head. These patients carefully "carry" the head, and when shouting, they turn their whole body;
  • Cough, sneeze, laugh.

Thus, if a sharp shaking of the neck is avoided, then the frequency and intensity of painful attacks can be reduced.

In addition to pain, often there is a crunch when moving in the neck. It occurs much earlier than other symptoms, and indicates a decrease in the height of the intervertebral discs and violation of their configuration.

Muscle stiffness and pain on palpation in the paravertebral (paravertebral points) is also a nonspecific, common symptom of a hernia of the discs in the cervical region, and a frequent symptom of osteochondrosis of the spine.

Particular symptoms depending on localization

Most often, a herniated disc of the cervical spine begins at level C3. The most commonly affected levels are C5 - C6, as well as C6-C7, and below, before the intervertebral disc between the seventh cervical and first thoracic vertebrae.

It should be remembered that there may be multiple hernias that are running in a row, both on the one hand and in a “staggered” order. As a result, symptoms of affection of one or several segments develop. Usually signs of radicular irritation are:

  • Paresthesia, hypesthesia, crawling, other sensitive disorders;
  • Muscle weakness, peripheral paresis (incomplete paralysis), lack of confidence in movements, muscular hypotrophy;
  • Vegetative-trophic disorders: redness or blanching of the skin, increase and decrease of skin temperature, "marbling" of the skin.

The following are the most well-known symptoms of cervical spine lesions at various levels:

  • Hernia C3 and C4 : pain in the neck and shoulder girdle develops, partial paresis of the diaphragm with the development of respiratory failure is possible;
  • Hernia C5-C6 (corresponds to the root of C6): there is pain and a decrease in sensitivity in the neck, upper arm, lateral surface of the shoulder, the radial surface of the forearm, up to the thumb and index finger. In the same departments there can be paresthesias. There may be paresis of the biceps, as a result of which there is weakness when bending the arm at the elbow and lifting the weight. Drops flexion - elbow tendon reflex;
  • Hernia C6-C7 (corresponds to the root of C7): Neck pain also worries, but unlike the previous location, there is a decrease in sensitivity in the zone of the index and ring fingers. Drops extensor - ulnar reflex (with triceps). There is a weakness when trying to straighten the arm in the elbow, the triceps muscle of the shoulder is affected, as well as the elbow extensor of the wrist. Sometimes there is an atrophy of a tenor, or muscles of an eminence of a thumb ("a fleshy" place on a palm);
  • Hernia C7-Th1 . Corresponds to the last cervical segment C8. It is manifested by pain, paresthesia, decreased sensitivity in the little finger, the ulnar half of the ring finger (closer to the little finger). There is a weakness in the extensors of the wrist and the muscles of the hand.

You need to know that sometimes there is such a pronounced narrowing of the adjacent intervertebral holes caused by many hernias that there is compression not only of the nerve roots corresponding to the segments, but also of the radicular artery, which flows into the anterior spinal artery.

This leads to a lack of blood circulation in the spinal cord, which can be so pronounced that spinal symptoms that speak of a stroke of the spinal cord, or transient ischemic attacks, can eventually join the above symptoms of radicular compression.

In addition, a hernia can directly narrow the lumen of the central canal and in rare cases result in compression of the spinal cord.

It must be remembered that the corresponding symptoms can be caused not by a hernia of the spine, but by damage to the peripheral nerves, for example, the median and radiotherapy (segment C8), or suprascapular nerve in the area of ​​the segment C6.

Treatment of hernia in the cervical spine

Neck hernia treatment

Treatment of osteochondrosis of the cervical spine is the best method of prophylactic treatment and hernia. Everyone knows these methods, list them.

Non-medicinal methods include:

  • sleep prevention, the acquisition of an orthopedic mattress and pillow, or a roll for sleep;
  • acupuncture, the use of Hippko, Hipplicator, Kuznetsova;
  • therapeutic exercises, swimming;
  • therapeutic and preventive massage;
  • manual therapy;
  • balneotherapy, mud therapy;
  • physiotherapy.

Medicinal methods include:

  • The introduction of nonsteroidal anti-inflammatory drugs (NSAIDs) for exacerbations (Ketonal, Movalis, Ksefokam, Celebrex, Ibuklin) for exacerbations. When treating a hernia in the cervical spine, these remedies help reduce pain and inflammation. Used both intramuscularly and in pill form. Together with them, it is necessary to take omeprazole prophylactically to reduce the risk of gastric ulcer;
  • Centrally acting muscle relaxants are tolperisone and tizanidine, or "Mydocalm" and "Sirdalud." Used intramuscularly courses to reduce the tone of skeletal muscles. This leads to the opening of the "vicious circle", improving the blood supply to the neck muscles, reducing the severity of pain;
  • Multivitamin group "B". This is "Milgamma", "Milgamma Compositum". They contribute to an increase in sensitivity, the elimination of paresthesias and the normalization of the nervous trophism. It is advisable to take them in courses, in the form of intramuscular injections;
  • Chondroprotectors. Contribute to the normalization of the metabolism of cartilage tissue. When the hernias are formed, their reception does not make sense; they are shown only when there are no protrusions and hernias yet. Used as a combination of drugs with NSAIDs (for example, "Teraflex Advance"), and in pure form, for example, "Alflutop".

Surgical treatment

Treatment of hernia in the cervical spine

In the event that conservative treatment of a hernia in the cervical spine was ineffective, then surgery is needed. What are the indications for surgery?

  • Strengthening pain syndrome, which is not stopped;
  • The progression of muscle weakness, paralysis and paresis;
  • The appearance of spinal symptoms associated with compression of the spinal cord.

Hernia of the cervical spine is most often reduced to performing microdiscectomy from a small access. Large incision is required. In addition to removing the disc, the second stage is to stabilize between adjacent vertebrae.

This is due to the fact that mobility is high in the cervical region. In addition, this achieves a normal distance between the vertebrae, and the restoration of the foraminal (intervertebral) blood flow. To do this, use your own bone autograft, which is taken from the pelvic bone of the patient, which is inserted between adjacent vertebrae, and after several months it grows together with them.

Thus, the price for treating pain and paralysis is a minor limitation in the neck.

A more modern technique is to install a cage, or mesh, containing the patient’s bone chips. Over time, this cage also sprouts bone tissue, immobilizing two adjacent vertebrae.

The most modern method is the installation of an artificial intervertebral disc, which completely replaces the remote one, retaining its elasticity and mobility in the area of ​​operation. Artificial disk has the same mobility and depreciation properties as human cartilage.

Similar endoprosthetics of the cervical disc can be made for 35-40 thousand dollars abroad.

In conclusion, we can say that a hernia of the cervical spine, the symptoms and treatment of which we have examined, does not occur suddenly. And always, in one degree or another, the patient loses precious time.

Timely diagnosis and treatment of hernia in the cervical spine, already at the stage of minimal changes, will allow patients to do without surgery in a large number of cases.

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