The spine is made up of bones called vertebrae and soft intervertebral disks that separate the bony vertebrae. A herniated disk is a condition that occurs when the disk ruptures or becomes out of place according to MedlinePlus. If the disk impinges on a nerve of the spinal cord, it can lead to pain, numbness, and weakness. A herniated disk is typically seen on MRI imaging and can be symptomatic or asymptomatic.
Medications
Medications used to help with symptoms from a herniated cervical spine disk include muscle relaxers, analgesics and anti-inflammatory medications according to the American Academy of Orthopaedic Surgeons. Muscle relaxer medications include diazepam, cyclobenzapril, tizanidine, baclofen, carisoprodol and gabapentin. Analgesics given for cervical spine pain can include vicodin, percocet, hydromorphone, codeine, MS Contin and oxycodone. Anti-inflammatory medications given for herniated disks include ibuprofen, naproxen, diclofenac, and meloxicam.
Physical Therapy
Physical therapy helps to strengthen the muscles and improve range of motion of the spine. Some patients do very well with massage to help loosen up tight muscles. Physical therapy can be helpful in conjunction with medications and surgery to help treat the herniated disk. Some patients benefit from use of a cervical collar to help decrease inflammation around a nerve root and relieve muscle spasm.
Anterior Cervical Decompression and Fusion (ACDF)
ACDF is a surgery that involves an incision in the front part of the neck. The disk is removed surgically and replaced with a bone graft to allow for the vertebrae to fuse. Fusion helps to limit motion and therefore decrease pain. A plate is inserted over the anterior vertebrae to help keep the vertebrae from moving as the bone begins to fuse the vertebrae. This surgery helps to decompress the nerve roots and is associated with low rates of infection and wound complications according to the AAOS Comprehensive Orthopaedic Review.
Posterior Decompression
Posterior decompression involves making an incision over the posterior aspect of the neck. The surgery involves decompressing the nerve root by removing the lamina and possibly removing the herniated disk according to the AAOS Comprehensive Orthopaedic Review. The surgery can involve a fusion with bone and/or instrumentation.
Cervical Disk Replacement
Cervical disk replacement is a newer technology that may be more commonly used in the future according to the AAOS Comprehensive Orthopaedic Review. This involves a ACDF procedure with placement of an artificial disk instead of a bone graft. There are no plates and screws associated with this procedure. Long-term benefits of this procedure are currently being studied.
References
- MedlinePlus: Herniated Disk
- "AAOS Comprehensive Orthopaedic Review"; Dr. Jay Lieberman; 2008.
- American Academy of Orthopaedic Surgeons: Herniated Disk
