Cervical Disc Herniation Treatment Options
Most cases of acute disc herniation resolve within weeks after symptoms begin. When symptoms last more than three weeks, nonsurgical measures are first line treatment for acute herniation. The majority of cervical disc herniations do not require surgery.
When symptoms are mild, your Dallas Neurosurgical & Spine specialist will recommend nonsurgical management to decrease pain and improve function. This may include the short-term use of a cervical collar to support and stabilize the neck, physical therapy, over the counter pain and anti-inflammatory medications, and possibly oral steroids.
Heat and cold therapy can help ease inflammation. Muscle relaxants may be ordered to relieve muscle spasms. Epidural steroid injections can provide pain relief for some and can improve pain enough that physical therapy can begin. Nonsurgical measures do not relieve the compression caused by a herniated disc. If nonsurgical measures do not relieve symptoms within six weeks, surgery may be recommended.
The goal of surgery is to decompress the nerves and cord and ensure mechanical stability. The decision about the best surgery for you is tailored to your specific case, including your age, comorbidities, bone density, etc., with the goal of achieving the best long-term outcome.
In the most severe cases, when symptoms persist, progressive nerve changes including spinal cord swelling and severe compression exist, or more than a single disc herniation is involved, surgery may be recommended to relieve pressure on spinal cord and affected nerve roots.
There are several common surgical procedures available including:
- Minimally Invasive Anterior Cervical Discectomy and Fusion (ACDF) – this is the gold standard treatment for chronic pain from a herniated cervical disc compressing the spinal cord or nerve roots. Complications are rare. The protruding part of the disc is removed to relieve pressure on the spinal cord or affected nerve root, and the vertebrae are fused with a bone graft and metal (titanium) hardware to stabilize the area. It requires only a small one-inch incision! However, there are some cases where discectomy without fusion can be performed safely and effectively.
- Anterior Cervical Corpectomy and Fusion – This procedure may be recommended when partial cervical discectomy and fusion are not an option. In a corpectomy the entire damaged cervical disc must be removed along with any degenerated vertebrae in order to decompress the cervical spine. The removed vertebrae are replaced with a bone graft and titanium hardware to ensure stability.
- Cervical Laminectomy – this procedure helps ease pressure on the nerve roots or spinal cord by removing all or part of the spinal lamina to widen the spinal canal.
- Cervical Laminoplasty – this procedure involves enlarging the cervical vertebral canal and is used to treat multiple level cervical disc herniation and stenosis.
- Artificial Disc Arthroplasty – this procedure involves removal of the diseased cervical disc and replacing it with an artificial disc.
- Posterior Cervical Discectomy – a procedure in which the offending disc herniation is trimmed to relieve pressure on the nerve. The procedure does not involve fusion.
This list is not inclusive. Your Dallas Neurosurgical & Spine specialist may combine procedures or add new techniques and advanced procedures to achieve the goal of relieving your pain and restoring function. Contact us to schedule a consultation to receive the correct diagnosis and all available treatment options for your condition.