General terms used to describe disk problems include herniated, ruptured, protruded, slipped, and prolapsed disk. However, they all mean the same thing and refer to a portion of the intervertebral disk which pushes itself onto the spinal cord or spinal nerve roots. A disk herniation at C3 is rare compared to other cervical disk herniations, according to the Chicago Institute of Neurosurgery and Neuroresearch, but when it occurs the compression of neural tissue causes a variety of symptoms.
Types of Symptoms
When an intervertebral disk herniates, the nucleus pulposus, or inner core material of the disk protrudes into the space occupied by the spinal cord or the spinal roots exiting the spinal cords. Pushing on these neural tissues produces pathological conditions which can be temporary or long lasting. The resulting effect of the disk material pressing on these neural elements is loss of the affected neuron's ability to conduct nerve signals, causing signs of sensory and motor impairment. If the disk pushes onto the spinal roots, it produces a radiculopathy, also called a pinched nerve. It is characterized by specific alterations of sensory and motor function. When the disk material compresses the spinal cord, it produces myelopathy with other distinct deficits in sensory and motor function.
Sensory
Disk herniation resulting in radiculopathy or myelopathy can be characterized by several sensory dysfunctions. As a result of radiculopathy, pain is the most common symptom, which can be felt in the neck, the back of the head, inside the shoulder blades, and more rarely between the shoulder blades. Also, there can be dizziness when the neck is bent backward or turned sideways. There also can be pain behind the eyes and behind the ears. More involved radiculopathy with extended neuronal damage may include symptoms such as pain, but only along the shoulders, arm and hand. It may also include numbness in the hand and fingers. Even more extensive involvement of the spinal roots will produce numbness primarily in the arms, torso and legs, the Chicago Institute notes.
Motor
When the third cervical disk herniates, motor impairment generally does not manifest markedly. Radiculopathy and myelopathy can manifest as motor impairments which are almost always accompanied by sensory involvement. These motor symptoms primarily include weakness in the arms. Also, there can be difficulty moving the neck. Extensive neurological involvement where the disk pushes onto the spinal cord and affects its central interior region can result in more severe motor impairment such difficulty with balance and walking abilities. The patient generally feels as though the legs are clumsy or spastic. These are symptoms of myelopathy, and also may include other symptoms such as abnormalities in controlling the bladder and bowels.
Other
Rarely, the nucleus pulposus will herniate secondary to trauma. This produces sensory loss around the mouth, as well as diffuse and nonspecific neck and shoulder pain. Also, decreased reflexes and upper limb, rather than lower limb, sensory and motor dysfunction may occur.
References
- Chicago Institute of Neurosurgery and Neuroresearch
- Jho Institute for Minimally Invasive Neurosurgery
- "Spine"; The Clinical Presentation of Uppermost Cervical Disc Protrusion; T. Chen; February 2000
- "Journal of Neurology, Neurosurgery and Psychiatry"; Midcervical central cord syndrome: numb and clumsy hands; M. Nakajima and K. Hirayama; June 1995
- Chiropractic Research: Clinical Presentation of Upper Cervical Disc Herniation
