Relieving the pain of a cervical herniated disk

J. Rafe Sales, M.D.
Orthopedic spine surgeon, Providence Spine Services

Published November 2012

A cervical herniated disk is one of the more common cervical spine conditions treated by spine specialists. It usually develops in people 30 to 50 years old, and although it may originate from some sort of trauma to the cervical spine, it often starts spontaneously.

It’s often accompanied by arm pain, or radiculopathy, which occurs when the herniation “pinches” or presses on a cervical nerve, causing pain to radiate along the nerve pathway down the arm (Figure 1). Muscle weakness also may be present.

Figure 1: A herniated disk causing severe nerve compression

Figure 2: Artificial disk replacement using The PRESTIGE Cervical Disc

Figure 3: Minimally invasive cervical fusion using LDR ROI-C

"I can't live with this"

Rachel Frazier’s arm pain from a cervical herniated disk was so severe that she couldn’t sleep at a night. How a short procedure brought immediate relief. Read her story.
Most of the time, this pain can be controlled with anti-inflammatory medication or oral steroids. There are also a number of nonsurgical treatment options, such as physical therapy, chiropractic manipulation, osteopathic medicine and simple activity modification. If the pain gets better, it is acceptable to continue with conservative treatment. 

If the pain is severe or lasts longer than six weeks, however, spine surgery is an excellent option.

Surgery for a cervical herniated disk is generally very reliable, and with an experienced spine surgeon, it carries a low risk of failure or complications. In terms of relieving arm pain, the success rate for cervical herniated disk surgery is greater than 95 percent.

Spine surgery can be done a number of ways. A smaller disk herniation sometimes can be repaired through a minimally invasive posterior decompression (laminotomy) performed on an outpatient basis. If the stenosis is profound, then a decompression from an anterior approach is appropriate.

After the decompression, an implant of some type must be placed to prevent a deformity. This is usually a disk arthroplasty device (Figure 2), which allows continued motion across the segment, or a fusion implant (Figure 3), which links the two bones together so that no motion occurs.

Newer devices introduced in the past few years allow a minimally invasive technique to repair these problems. In most patients, a one-level or two-level procedure is now done through a small incision on an outpatient basis.

Some of the most recent devices, such as the one pictured in Figure 3, allow a surgeon to perform a fusion without a large plate on the front of the spine. This allows for even smaller incisions and lowers the rate of postoperative dysphagia. With these new implants, most patients can return to work in one to two weeks, and get back to the life they love.

Clinical articles by J. Rafe Sales, M.D.