Why does neck hernia occur and what is the treatment?

The degree of herniation can range from simple herniation to sequestration of the nucleus pulposus. Neck hernias are caused by changes in the discs between the cervical vertebrae. The nucleus, located in the middle of the structure called the disc, herniates mostly posteriorly through the tear in the surrounding annulus. This herniation is mostly posterior-laterally or posteriorly towards the middle. Posterior-lateral herniation presses on the nerve roots going to the arms and hands, while herniation in the middle presses on the spinal cord. Compression of the spinal cord is called myelopathy. C5-6 and C6-7 disc levels cause the most common nerve root compression symptoms, while C4-5 and C7-T1 lesions are less common. C3-4 lesions are very rare. Neck hernias can be divided into two groups as soft hernia and hard hernia. Cervical disc disease is the problem of the adult age group. Hard hernias are seen in elderly patients. In neck hernias, patients describe a sharp pain and burning sensation in the affected area. Motor and sensory losses and reflex losses can be seen due to the affected nerve root. Patients typically have widespread neck and arm pain. Pain often radiates to one arm and usually indicates root involvement. Patients usually tend to keep their arms up and behind the head. In this way, the pain is relieved. Again, removing the head from the symptomatic side reduces pain. A common condition in adults is compression on the spinal cord. Depending on the location and severity of the pressure on the spinal cord, various signs and symptoms may occur. Loss of strength in the legs is a very important symptom. Magnetic resonance imaging (MRI) for diagnosis gives very important information in the examination of soft tissues such as spinal cord, nerve roots, disc space and cerebrospinal fluid. Conservative treatment (medicine, neck brace) is at the forefront in the treatment of neck hernias. The results of conservative treatment, especially in radiculopathy, are promising. Physical therapy may also be considered. In cases where the pain does not go away, surgery should be considered in the case of advanced or progressive neurological deterioration. Spinal cord compression is a very serious condition. Patients should be followed very closely if surgery is not recommended. The main goal of surgical treatment is decompression of the compressed neural structure. However, the structure of the cervical spine should be taken into account when making a treatment plan. In addition to decompression, fusion planning can be performed especially in cases where lordosis is impaired, kyphotic deformities, and instability. It is aimed to preserve cervical motion with disc prostheses that have developed recently.