On this page, we will try to explain the details about the causes and findings of cervical hernia, diagnostic methods, cervical hernia prices, cervical hernia surgery options and what you should do after cervical hernia surgery. I wish you all healthy days.
What is Cervical Hernia (Cervical Disc Herniation)?
The cervical hernia is one of the problems that our patients face very often. There are 7 vertebrae in the neck area and structures called discs between them. In addition, there are 2 small joint structures connecting both cervical spines, connective tissues connecting the back parts of the spines. The disc structure between the vertebrae has a capsule on the outside and soft disc material on the inside. The task of the disc structure between the vertebrae is to evenly distribute the load on the vertebrae. The common task of the disc and joints is to ensure that the arrangement of the cervical spine remains in order and to help the neck movements to be made. With their help, it is possible to make the neck move in all directions.
With age, the degenerative process in the spinal system increases, and calcification among the people occurs in medicine, which we call spondylosis. If this process develops in the neck, it can cause neck pain to increase. With increasing age, the amount of water in the discs between the cervical vertebrae decreases, and the flexibility of the disc is lost and it becomes unable to distribute the load on the spine evenly.
Later, deterioration occurs in the outer layer of the disc and tears may occur in the later period. In the future, from these tears, the jelly-like structure called the nucleus pulposus in the internal structure of the disc comes out and presses on the nerves leading to the spinal cord or arms. This condition is called cervical disc herniation in medicine and cervical hernia among the people. As a result of the compression of the nerve leading to the arms of the resulting disc, that is, the hernia, pain in the hands and/or tingling in the hands in our patients may occur in our patients and loss of strength in the later period. Due to the pressure of the ascending hernia fragment on the spinal cord, there may be problems in the legs, difficulty walking, or the presence of inappropriate reflex findings.
What are the Causes of Cervical Hernia?
The cervical hernia is a problem that is mostly seen between the ages of 20 and 40. Causes of cervical hernia include heavy athletic activity, making a reverse movement, trauma, falling from a height, and traffic accidents. As a result, a rupture occurs in the outer layer of the disc tissue between the two vertebrae in the neck area and the gelatinous soft structure called nucleus pulposus inside the disc comes out, that is, herniates and presses on the nerves leading to the spinal cord or arms, creating findings in patients.
Symptoms of Cervical Hernia
Our patients encounter neck pain more frequently in daily life, especially after office life has become much more up-to-date. Neck pain can be seen more in some occupational groups such as office workers who work intensively at a desk and require computer use, teachers, physically intensive workers, athletes, and drivers. However, not every neck pain may be caused by a cervical hernia. A large part of neck pain may be a pain that does not require surgical intervention due to the joints where the muscle-tendons and spines are connected to each other.
The most obvious symptoms of cervical hernia are neck pain, pain radiating to the back, shoulder blade, upper part of the arm, forearm part or hands, tingling and numbness in the arms or hands, loss of sensation, and sometimes a feeling of electrification. In the later stages of cervical hernia, loss of strength in arms, hands, or fingers and decrease in reflexes may be seen. If there is pressure on the spinal cord in the later periods when the cervical hernia is not treated; may experience gait disorders, loss of strength in the legs and tingling, numbness, inflammation, or urinary and/or fecal incontinence.
Cervical Hernia Treatment Options
In the pain caused by cervical hernia, mostly a short-term rest period, pain relief treatment with a basic medication and sometimes limiting the movements of the neck by using a neck brace; may contribute to the reduction of pain and the treatment of neck pain. However, surgery is required in patients with symptoms due to loss of strength, severe spinal cord and nerve compression leading to the arms. Sometimes, it may be necessary to plan surgery for patients who cannot be treated with physical therapy or algology (pain science) applications, or for patients for whom special drug treatments (neuropathic pain treatment) are not successful.
Cervical Hernia Surgery Methods
In the patient diagnosed with cervical hernia, there are two options in front of us at the stage of surgical decision-making. One of them is the decision to perform the surgery from the front and the other from the back approach. In the frontal surgical intervention, which is among the cervical hernia surgery options, a horizontal incision of 4-5 cm is usually made on the right side of the neck and then the skin tissue and superficial muscle layer is passed and the jugular vein is seen between the neck muscles. With the retractors we use specially to reach the spine, the jugular vein is pulled to the right side and the food and windpipe to the left side and the anterior region of the cervical vertebrae is reached.
Here, in order to determine which distance we will operate, a marking is made and the level at which we will perform surgery is determined by the X-ray film taken during the operation. Then, the surgical microscope that we will use for the next stage of the operation is brought to the operation site and microdiscectomy process and at the same time the hernia part that presses on the nerve leading to the spinal cord and/or arm is removed using a microscope.
Then, instead of the emptied disc material, cages made of PEEK material are placed between the two adjacent vertebrae to fix this area or movable disc prostheses if the patient's cervical spine structure is appropriate.
Before terminating the operation, X-ray film is taken to see the placement of the cage or removable disc prosthesis between the two vertebrae. Then, bleeding control is performed and then the operation is terminated by closing the incision site so that there is no need to take stitches. Another approach among the cervical hernia surgery options is the surgical intervention performed on the back of the neck using a microscope. If the hernia is not in the midline and is just below the nerve root coming out of the spinal cord or just at the beginning of the nerve canal leading to the arm, then surgical intervention on the back of the neck may be preferred. Since there are no important structures such as food and windpipe, jugular vein, nerve leading to vocal cords in the surgical intervention performed from the back, the surgical risk is lower than the surgery performed from the front. However, since muscle stripping and bone tissue removal are involved in the cervical hernia surgery performed from the back, the complaint of neck pain may be slightly higher after the operation than the cervical hernia surgery performed from the front.
Exercise After Cervical Hernia Surgery
After cervical hernia surgery, we start exercise programs for our patients in the 3rd month after surgery.Our patients should do the neck exercises we give regularly at least 3 days a week. Often, our patients stop exercising their neck after a period. Cervical hernia surgery exercises should be continued throughout life.
Recovery Process After Cervical Hernia Surgery
- You can go home sitting in the car.
- You can do your daily simple activities at home.
- Use clothes that are opened and closed from the front for a while after cervical hernia surgery.
- The first week may be difficulty in swallowing, a feeling of being stuck in the throat. The problem is edema in the esophagus. For this reason, prefer soft foods (pasta, soup, rice pudding, custard, etc.) for the first 3-4 days.
- If there is hoarseness after cervical hernia surgery, it is mostly temporary. Persistent hoarseness is very rare.
- In the first days, there may sometimes be complaints such as pain, burning sensation, and stinging at the incision site in your neck. Therefore, do not worry. For postoperative incision site pain, you will be prescribed the necessary medications by me during discharge. Your postoperative arm pain will pass immediately. Problems such as drowsiness, tingling may take a little longer to pass.
- If the neck brace is recommended by me, I will tell you how to use it.
- When you run out of medications given to you when you are discharged, you do not need to take medication unless you are told otherwise.
- Stop smoking after cervical hernia surgery.Because smoking adversely affects the fusion of the spines called fusion created by the cage used in surgery.
- Make sure that your bed and pillow are suitable for neck health. Be sure to use your bed for sleeping.
- Come to the control on the appointment day given to you after cervical hernia surgery. The necessary information to take a bath will be given to you at this check.
- After discharge, the first dressing of the wound site will be made by me and will be closed. After being closed for 2 days, open the dressing yourself and leave it open.
- There is no need to remove stitches. The incision site is sutured from the inside. Sometimes there are situations when it is necessary to stitch from the outside, then your stitches are removed on the seventh day.
- If there is redness, swelling, discharge at the wound site, call me.
- Leave the neck brace you started to use after cervical hernia surgery after 15 days.Make sure that the seat cushion behind your head in the vehicle is the same height as your head.
- After discharge, I recommend that you rest at home for 3 days, then you can go out with your neck brace.
- After cervical hernia surgery, those who work at the desk can return to work after 15 days if they wish. But those who work in heavy work should rest for 4 weeks
- Do not carry more than 3 kg of weight in your hand for the first 4 weeks. After 1 year, take care not to carry a total weight exceeding 6 kg in both hands.
- Do not drive for 10 days after cervical hernia surgery.
- You can make short plane trips. However, do not take long (such as oceanic) air journeys for the first 30 days.
- Do not do sports activities that require contact for the first 4 months. Just walk and swim.Then you can start non-contact sports activities again.
- The period we call the full recovery period after cervical hernia surgery is 4 months and after.After this period, you can do many of your activities as you would during your healthy period.
- Pay attention to the issues you have been warned about in your daily activities and my recommendations for protecting your neck health.
- After returning to your normal daily life, follow the exercise program given to you and continue swimming exercises if possible.
Cervical Hernia Surgery Risks
There are also some risks that may occur in cervical hernia surgery.Some of the risks and complications that may occur are: Anesthesia, bleeding, spinal cord injury, surgery cannot eliminate pain, numbness, loss of muscle strength and other existing complaints, infection, temporary or permanent damage to the nerve leading to the vocal cords, nerve root injury, respiratory problems, stroke as a result of damage to the jugular vein, postoperative recurrence.The rate of these risks is very low, but it is a legal obligation to explain these risks to every patient who accepts surgery.
Cervical Hernia Surgery Prices
We receive a large number of patient calls who want to learn the price for cervical hernia surgery.The publication of surgery prices in a digital environment open to all our patients is not appropriate in terms of professional ethical rules.We make the surgery fees of our patients according to the pricing list in the "Physician Practices Database" used by all other private hospitals and prepared by the Turkish Medical Association.Thus, our patients know according to which standards the price offered to them is determined, make sure of the transparency of the price and have the opportunity to compare prices.