The spine allows our body to stand upright and provides our mobility. The spine consists of bones called vertebrae ( vertebrae). Between the vertebrae there are supporting tissues called Decussations. Intervertebral Decals (between the vertebrae) prevent the load from being placed on the vertebrae and provide ease of movement.
A neural network called the spinal cord passes through the middle of the spine. There are 7 vertebrae in our neck and 5 discs between them. Dec. The inside of the discs is filled with a substance called gelatinous. This substance is called the nucleus pulposus. On the outside of the discs, they are wrapped with annulus fibrosus, a hard tissue, and are supported by various conn November tissue elements, such as ligaments or muscles.
the first of the 7 neck vertebrae is located just below the skull. This vertebra, expressed as C1, has been given the name ”atlas". The atlas vertebra, which is conjoined with the C2 vertebra underneath, takes part in the rotation movement of the head. 8 Pairs of nerve roots emerge from a total of 7 vertebrae located in the neck Deceleration area. Changes occurring in the vertebral region can cause various symptoms by putting pressure on these nerves directly or on the canal.
Ingredients
What is a cervical hernia?
What causes a neck hernia?
What are the symptoms of a cervical hernia?
How is a cervical hernia diagnosed?
How is neck hernia treatment performed?
What is a cervical hernia?
There is a gelatinous substance between the bones of the spine, called vertebrae, which is responsible for the absorption of shock waves that occur during movements. Dec. The displacement of this substance towards the spinal cord canal as a result of damage to the disc structure is defined as a hernia.
What causes a neck hernia?
Abrasion and loss of function occur in the discs as a result of traumas, difficulties, long-term inactivity and water loss of the disc due to old age. The outer layer of the disc is eroded or torn, and the gelatinous fluid inside leaks into the vertebral and nerve Decembers. This clinical picture is called cervical disc herniation (cervical disc herniation). The disk loses its normal property over time and calcifies. It puts pressure on the nerves around you. After the disc structure extends into the canal in the herniated area and the nerves in this area are affected, the body responds to these changes with an inflammatory response. As a result of these events, symptoms specific to cervical hernia appear in a person.
Herniation in the neck area usually occurs on the back and sides, where the annulus fibrosis, the support structure of the vertebrae, is thinner.
The main causes of cervical hernia can be considered as looking at a point by keeping the neck motionless for a long time, sitting in front of the computer and TV for a long time, not exercising and being in an environment with cold air conditioners. Sometimes the problem can arise only structurally. Familial factors are also important in cervical hernia. If a person has a cervical hernia in his family, the probability of its occurrence also increases. Blows to the neck and previous accidents can also lead to a neck hernia. In addition, neck hernia can also come across as an occupational disease. Neck hernia is common in those who work in domestic services, drivers, bankers and those who do professions that need to be worked with computers for a long time.
Aging can prepare the ground for the development of a cervical hernia. As a person's age progresses, Decaying discs located between the vertebrae may occur. With the disappearance of the gelatinous property of the supplement over time, the development of a hernia becomes easier in a person.
The symptoms that occur after the development of a (chronic) cervical hernia in a long process that occurs as a natural part of aging may tend to progress and are usually insidious in onset. In a cervical hernia that occurs suddenly (acutely) due to trauma or other reasons, the symptoms begin immediately after the event that caused the hernia, and more serious symptoms occur compared to the development of a chronic cervical hernia.
What are the symptoms of a cervical hernia?
There is an increased risk of herniation in the neck area that occurs with age in both women and men. Decapular hernia is detected especially in people in the age group between 30 and 50 years. It is a condition that is encountered 1.5 times more in women than in men.
Neck pain is often seen in society, and one of the biggest causes is a neck hernia. Cervical hernia, often 5. and 6 between the vertebrae, while in the second frequency it Decays to 6. and 7. it is seen between the vertebrae. Dec. This is due to the fact that these vertebrae are very mobile and are more exposed to stress. Various symptoms may occur with the development of a cervical hernia in a person:
Pain in the neck, back, arms and shoulders
Numbness and feeling defect in the arms
Tingling in the arms
Loss of strength in the arms
Decrease in reflexes
Thinning in the arms
The symptoms expressed as radiculopathy describe complaints that begin in that area after a hernia and spread to the lower parts of the body. After a cervical hernia, the pain that a person feels in the neck may spread to the shoulder, arm and hand. In addition to pain, people with cervical radiculopathy may be accompanied by symptoms such as burning, tingling and weakness from the neck to the hands.
In cases that have not been intervened and have progressed, caution should be exercised, as there may be a complete loss of sensation and the development of paralysis in the affected areas of the patients.
How is a cervical hernia diagnosed?
When the patient goes to the doctor with the complaints listed above, the doctor first performs a detailed physical examination. Later, he may order various biochemical examinations and radiological tests such as MRI, computed tomography and EMG. In these examinations, the location of the cervical hernia, the severity of the hernia and the rate of nerve involvement can be determined.
Biochemical laboratory tests can be effective in ruling out the presence of any underlying rheumatological or malignancy, such as cancer, in people presenting with cervical hernia complaints.
X-ray (flat graphy) is the first radiological examination that may be required for the diagnosis of cervical hernia. X-ray x-rays can give an idea about the sequence of the bones that make up the spine and whether there is any degeneration in these bones. The most sensitive radiological examination for the structure of bones is computed tomography (CT) Sag. With computed tomography, chemical changes such as calcification (calcification) in the herniated area can also be detected.
Magnetic resonance imaging (MRI) is an ideal radiological examination for soft tissue changes, especially in the area where herniation occurs, and for complete imaging of the hernia. MRI, which also allows the exit point of the nerve root to be examined, is an important radiological examination method for detailed analysis of the hernia.
Apart from radiological methods, electromyography (EMG) and nerve conduction studies, which are classified as electrodiagnostic procedures, can also be used in the diagnosis of cervical hernia. These tests are of diagnostic importance especially in patients who develop cervical radiculopathy.
At the first stage of the diagnostic approach to cervical hernia, it is questioned what the patient's complaints are, when these complaints started, what are the factors that increase and Decelerate the symptoms, whether there are signs of radicular (reflected) pain among the person's complaints, and whether he has received any treatment for this in the past.
With the physical examination performed by the physician, it is examined to what extent the patient's joint movement width is affected and how complaints are affected by movements. Some of the complaints are related to certain nerve roots, and these symptoms can give an idea of which area of the spine the patient's lesion is located before radiological diagnostic attempts:
Symptoms that Occur Due to the Influence of the C2 Nerve Root
A feeling of pain in the eyes and ears and a headache are among the symptoms that may occur due to the influence of the c2 nerve root after the development of Decumbent hernia. Lesions of this area are especially important in people with rheumatoid arthritis, such as rheumatoid arthritis, because they may indicate a problem between the skull and the first vertebra, the atlas. Dec.
Symptoms that Occur Due to the Influence of C3, C4 Nerve Roots
Tenderness and spasm in the neck, shoulder and back muscles that are not obvious are among the mild complaints that occur due to pressure on the c3 and c4 November nerve roots in cervical hernia patients.
Symptoms that Occur Due to the Influence of the C5 Nerve Root
When the c5 nerve root is affected due to a cervical hernia, a person may experience symptoms such as loss of sensation on the sides of the arms October in addition to neck and shoulder pain. Movements such as lifting the shoulders up and breaking the arm from the elbow may also be affected and the patient may not be able to do these movements when asked to do so. When the patient's biceps (inner side of the elbow) reflex is examined, it is detected as decreased.
Symptoms that Occur Due to the Influence of the C6 Nerve Root
As with the C5 nerve root, complaints of neck and shoulder pain occur when the c6 nerve root is affected after the development of a cervical hernia in a person. Loss of sensation may occur on the sides of the arms and hands, as well as on the last 2 fingers of the hand. Some movements involving the elbow and wrist are affected, and the patient may have difficulty performing these movements. During reflex examination, the patient's brachioradial (side of the wrist) reflex is detected as decreased.
C7 Symptoms Caused by Nerve Root Involvement
As with other nerve roots located in the neck region of the spinal cord, the influence of the c7 nerve root due to a cervical hernia causes a person to complain of neck and shoulder pain. Loss of sensation in the back part of the forearm and the middle finger and restriction of wrist and elbow movements are among other symptoms that occur in these patients. Dec. The triceps (back arm) reflex is detected as decreased in these people.
Symptoms that Occur Due to the Influence of the C8 Nerve Root
Neck and shoulder pain accompanied by loss of sensation in the middle part of the forearm and hand are among the symptoms that occur due to the influence of the c8 nerve root Dec. At the same time, the movements of some other fingers, especially the thumb, and the grasping movement of the hand are detected to be affected in these patients.
Symptoms that Occur Due to the Influence of the T1 Nerve Root
When the t1 nerve root, which is located in the lowest segment of the nerve roots in the neck region, is affected, neck and shoulder pain appear as the main complaints, as in other nerve roots in the neck region. These complaints may be accompanied by weakness in finger movements and loss of sensation in the middle part of the forearm.
At the beginning of the symptoms that are most often detected in people, complaints such as neck pain and numbness, numbness and tingling that spread unilaterally to the arm are included. Neck hernia is considered important in patients with neck pain and other complaints because some of the symptoms that accompany neck pain may indicate an underlying malignancy (cancer) or infectious disease.
There are various conditions called alarm symptoms in cervical hernia:
Fever, chills, chills
Night sweats
Unexplained weight loss
The presence of an infectious disease in the patient's history, such as cancer, joint inflammation or tuberculosis, HIV
The use of immunosuppressive drugs used after various health problems or organ transplants
The pain does not ease in any way
Feeling of tenderness after the physician touches the vertebrae during the physical examination
Accompanied by problems with the lymph nodes located in the neck area (cervical lymphadenopathy)
If you also have the symptoms listed above, it is recommended to contact the nearest health institution and consult physicians who are specialists in neurosurgery and physical therapy.
How is neck hernia treatment performed?
The first priority of treatment is the patient's education. The patient is taught the correct posture and sitting position. It is necessary to avoid carrying heavy loads. Patients experience great benefit from local heat therapy during treatment.
Painkillers and November muscle relaxants are used as drug therapy. Physical therapy in the case of sessions can also be included in conservative (progress-inhibiting) treatment planning. During the first three days of the acute (sudden onset) period, the use of a lanyard may relieve the patient. Using a lanyard for a longer period of time is not recommended, as it may weaken November neck muscles. Pushing, pulling and stretching exercises can be performed on the neck with experienced physical therapists. Neck November exercises are recommended to strengthen the muscles around the neck vertebrae.
It is recommended that these exercises are performed without the knowledge and recommendation of the physician, they should not be performed unconsciously, as it may worsen the existing problem:
Neck Stretching Exercise
It is performed by slowly and gently moving the head to the back after lying on your back on a flat floor such as a bed. After the head is stretched back and neck tension occurs, the person is held in this position for 1 minute and then rested for 1 minute. The aggravation of the person's symptoms during this exercise, which occurs about 5-15 repetitions, indicates that the exercise should be discontinued.
Neck stretching exercise can also be performed by moving the head up while lying face down. The duration for the exercise performed in this way is between 5 and 10 seconds and is repeated 15-20 times. Dec.
Neck Retraction (Pulling) Exercise
The retraction exercise, performed in the supine position with the arms on both sides, is performed by moving the chin towards the chest. After the chin reaches the chest, this exercise is repeated approximately 15-20 times to the patient, who is held in this position for 5-10 seconds.
The purpose of these exercises is to increase blood flow in the hernia area, reduce stress and provide strength. In addition to these exercises, it is also important to avoid activities involving running, jumping, heavy lifting and sudden movements that will cause excessive pressure on the neck area, so that the recovery process is not adversely affected in cervical hernia patients. Caution should be taken as the person may experience the consequences of such harmful activities throughout his or her life.
The vast majority of cervical hernias heal without surgery. If the patient has progressive loss of strength in his arms and hands and the patient does not respond to other treatments, surgery may be considered. Cervical hernia surgery is an operation performed by neurosurgeons.
Spinal Injection Method for the Treatment of Cervical Hernia
If there are very severe arm pains, the doctor may inject cortisone drugs into the epidural space inside the spinal cord to relieve the pain. Spinal injection method is a treatment application performed directly to the hernia site by using radiological imaging. This treatment is aimed at reducing edema and inflammation in the nerve and disc. With cortisone injections, relief can be provided for some complaints of a person for a long time.
General Information About Neck Hernia Surgery
Surgical intervention may be required in approximately 10% of cervical hernia patients. The purpose of this surgery is to remove the part of the disc that presses on the nerve.
According to the procedure performed, this surgery is called a laminectomy or discectomy. In cases accompanied by advanced and neurological problems, or if the patient's complaints cannot be controlled despite other treatment methods, it is aimed to prevent re-herniation by removing the disc during the referred discectomy operation.
During the laminectomy procedure, the surgeon expands the area where the nerve roots come out, reducing the pressure in this area. This procedure, which is performed by entering through a small incision, is performed by the surgeon using a microscope.
Currently, herniated discs, especially in the lumbar region, are surgically completely removed and prostheses can be replaced. This procedure is performed while the patient is under general anesthesia. However, prosthesis application is not suitable for every patient. Especially in people with various joint inflammation or osteoporosis (bone resorption) diseases along with herniation, prosthesis-using interventions are not preferred in these people due to the fact that herniation occurs not only in one area, but also in many areas of the spine.