Neck pain is one of the most common medical problems in daily life. The most common neck pain is mechanical neck pain. Head, shoulder and arm pain may also accompany this pain. It is often caused by reasons such as posture-sitting disorder, trauma and injury. Most of those who work at desk jobs especially complain of this type of neck pain. Working by leaning forward while sitting, reading a book by keeping the neck bent for a long time, doing handicrafts, computer-tablet etc. to drive, to drive; Mechanical pain may occur due to reasons such as watching television while lying down, excessive sports and choosing a pillow that is not suitable for neck anatomy. Working with the neck fixed up or forward during housework often causes neck pain in housewives. Household chores where the neck is held in a certain position for a long time and forced, such as hanging curtains or washing dishes by hand, are among the leading causes. Pain relievers and muscle relaxants are used to treat this type of pain. Various exercises and correction of bad posture that causes pain are generally applied treatment methods.
Diseases and causes of neck pain include primarily mechanical neck pain, anxiety-stress, neck pain caused by traumas, neck hernia, calcification-narrow canal, rheumatic diseases (fibromyalgia, etc.) and infection and/or tumoral infections affecting the neck vertebrae and surrounding tissues. diseases occur. While surgery is applied to cases with instability due to trauma, neck hernia with progressive neurological deficit (loss of strength, numbness), calcification-canal narrowing (cervical spinal stenosis) and tumors pressing on the spinal cord, medication and physical therapy are sufficient for other pain factors.
When diagnosing a neck hernia by a neurosurgeon, three main issues are primarily evaluated. The type, severity, time of the patient’s complaints (pain radiating to the neck and arm); neurological examination findings (weakness and numbness) and radiological examination (cervical vertebra MRI). If the findings in these three criteria fully overlap, the diagnosis of neck hernia is made.
The main things to know are the following: Cervical hernia cannot be diagnosed by neck MRI alone. Not every neck pain is a neck hernia. The treatment of every neck hernia is not surgery.
Most of the patients diagnosed with neck hernia recover with non-surgical treatments. Pain control with so-called non-steroidal anti-inflammatory pain medications, the use of a neck brace, and appropriate physical therapy procedures often help.
In the case of weakness in the hands or arms accompanying severe arm pain, surgical treatment should be offered to the patient if severe nerve or spinal cord compression can be demonstrated by MR imaging to explain this.
There is a patient profile whose neurological findings are getting worse day by day, and while non-operative methods are wasted time in these patients, irreversible nerve damage is the most undesirable situation. It is recommended that these patients undergo surgery without delay. A group of neck hernia patients have severe neck and arm pain without loss of strength, and they cannot be relieved by any non-surgical treatment. The quality of daily life due to pain is severely impaired. In these patients, the pain disappears quickly with neck hernia surgery and allows them to return to routine life without any problems.
In neck hernias that require surgery, surgeries are currently performed in two ways, microsurgery, anteriorly or posteriorly. In mostly anterior neck hernia surgeries, a safe distance of the disc is reached between the esophagus, trachea and carotid artery, and the disc there is started to be emptied and cleaned until it is seen that the spinal cord and nerves are relaxed. Thus, the pressure that causes pain and weakness is eliminated. Then, in order to prevent the formation of kyphosis in the long term, either a bone graft called a cage or an artificial prosthesis called a disc prosthesis are placed. In posterior surgeries, thickened connective tissues and hernias where calcification and narrowing are prominent can be removed. The surgical technique is decided according to the patient’s findings or where the disc is pressing. After the operation, the patient can stand up on the same day. The hospital stay is usually one day. Mostly, the patient’s pain passes quickly and his strength improves. Drowsiness shows a little later improvement. In very delayed cases, it may not completely recover. In frontal surgeries, sore throat or pain when swallowing may occur in the first 1-2 days. It is recommended to use a neck brace for 3-4 weeks in patients who underwent fusion between the vertebrae after surgery.
