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NECK HERNIAS

The spine is one of the basic skeletal structures of our body and is shaped by bony structures called vertebrae. The seven vertebral bones in the cervical region form an important part of our spine. Between these bones are cartilaginous structures called intervertebral discs, which provide flexibility and make up 25-30 percent of the spine.

These intervertebral discs generally fulfill two basic tasks. Firstly, to provide support to the spine and secondly, to help spinal movements. The discs are made up of an outer layer of elastic fibers, the annulus fibrosis, which is surrounded on the inside by a structure called the nucleus pulposus, a gel-like core.

If there is a weakness or tear in the outer layer, the inner gelatinous nucleus bulges into the spinal cord and a cervical herniated disc is formed. Weakness in this outer layer can sometimes occur due to years of overload and incorrect movements. It can also develop suddenly due to accidents and sudden movements. Causes of a cervical herniated disc can also include harmful habits that disrupt the structure of the connective tissue, such as smoking, or chronic diseases such as diabetes. Contrary to popular belief, herniated discs are less common in older people, as the connective tissue hardens and loses elasticity with age.

The spine and cervical hernia form an important part of the complex structure of our body. Correct posture habits, a balanced lifestyle and regular exercise are important factors to maintain spinal health and prevent problems such as cervical herniated discs.

CAUSES

Aging Process:
With aging, the water content in the discs between the vertebrae decreases and the discs weaken. This can increase the risk of protruding discs.
Disc Damage and Attenuation:
Weakening or damage to the discs can push the gelatinous substance inside outwards, which can lead to a bulging or herniated disc.
Sudden Movements and Trauma:
Sudden movements, accidents or trauma to the neck area can cause disc damage, which can trigger a herniated disc.
Genetic Factors:
Genetic predisposition can influence the tendency of a person’s disc structure or spinal anatomy to develop a hernia.
Overload and Poor Posture:
Overloading, heavy lifting or persistent bad posture habits can increase pressure on the discs and contribute to herniated discs.
Smoking:
Smoking can reduce blood flow to the discs and lead to degenerative disc disease, which can increase the risk of a hernia.

SYMPTOMS
Pain and Severe Discomfort in the Neck:
A cervical hernia usually causes pain in the neck area. This pain can range from mild discomfort to severe pain.
Pain in Shoulders and Arms:
A cervical hernia can cause pain that can radiate from the shoulders to the arms. Tingling or numbness, especially in the arms and shoulders
Headache:
A cervical hernia can often also cause headaches. This headache is usually felt in the back of the neck and head.
Numbness in Hands and Fingers:
A cervical hernia can cause numbness or tingling in the hands and fingers by pressing on the nerve roots.
Dizziness and Instability:
A cervical hernia can sometimes cause dizziness or a feeling of unsteadiness. This can be caused by nerves being affected.
Muscle Weakness:
A cervical hernia that presses on the nerve roots can cause muscle weakness in the arms and shoulders. Feeling of weakness may occur.
Coordination Problems in the Hands:
A herniated disc in the neck can affect the control of the muscles in the hands, which can lead to difficulty in holding the hand or handling objects properly.
Low Back and Back Pain:
A cervical hernia can also spread to other parts of the spine and cause lower back and back pain.
Other Related Symptoms:
A herniated disc in the neck can sometimes cause associated symptoms such as tinnitus, vision problems, dizziness and nausea.

NON-SURGICAL TREATMENT METHODS FOR NECK HERNIAS

Rest and Activity Restriction:
Rest in the acute phase can reduce neck herniated disc symptoms. Activity restriction and avoidance of heavy loads are important.
Painkillers and Anti-Inflammatory Drugs:
Painkillers and anti-inflammatory drugs used under the supervision of a doctor can control pain and inflammation.
Physical Therapy and Exercise:
Physical therapy programs are suitable for strengthening the neck muscles, increasing flexibility and correcting posture. Exercises guided by a specialized physiotherapist can be useful.
Heat and Cold Applications:
Cold application can reduce swelling, while hot application can relax muscles and increase blood circulation.
Epidural Steroid Injections:
Epidural steroid injections administered by a doctor can help control pain and inflammation.
Manual Therapy:
Manual therapy and massage by a qualified physiotherapist can reduce muscle tension and relieve pain.

SURGICAL TREATMENT METHODS IN NECK HERNIAS

Discectomy:
A discectomy is a surgical procedure that involves the complete or partial removal of a herniated disc. This allows material that is pressing on the spinal cord or nerve roots to be removed. The surgeon performs the procedure in a minimally invasive way, usually using a microscope or endoscope.

Microdiscectomy:
A microdiscectomy is a type of discectomy procedure that allows the surgeon to enter through a smaller incision using a microscope or endoscope. This allows less damage to the surrounding tissues during surgery.

Laminectomy:
Laminectomy involves removing the bony structures at the back of the vertebrae, called laminae. This can be done to provide more space for the spinal cord or nerve roots.

Flexion-Distraction:
In this method, the surgeon tries to reduce the pressure on the disc by pulling the neck area slightly. This can relieve pressure on the spinal cord and nerve roots.

Servikal Foraminotomi:
Cervical foraminotomy aims to widen the narrowed foraminal space where the nerve roots leave the spinal cord. This can release structures that put pressure on the nerve roots.

Disc Arthroplasty (Cervical Disc Replacement):
Instead of removing the herniated disc, an artificial disc is inserted. This can help maintain spinal mobility.

Anterior Servikal Diskektomi ve Füzyon (ACDF):
ACDF is a surgical procedure used to remove the disc and fuse the vertebrae together. This method fuses the vertebrae together, usually using a graft or implant instead of a disc.

Posterior Servikal Diskektomi:

In this method, the surgeon enters the back of the vertebrae and removes the herniated disc. This can reduce the pressure on the nerve roots.

Each surgical procedure is chosen depending on the individual condition and symptom severity. Surgical treatment is usually considered a last resort and is performed when other treatment options have failed or in cases of significant nerve compression.