Cervical Disc Prolapse (Herniation / Bulging)

Spine Conditions

A disc prolapse (or herniation/bulge) is a rupture or bulge of an intervertebral disc. It usually occurs when the soft, jelly-like centre (nucleus pulposus) of the disc escapes from its usual position and bulges into the spinal canal. This bulge can put pressure on spinal nerves or spinal cord. Material from the herniated disc can cause an inflammatory reaction as well, which can further contribute to nerve irritation. Compression and/or irritation of the spinal nerves are usually the cause of your symptoms.

An intervertebral disc can rupture or bulge suddenly as a result of excessive pressure, bending or heaving lifting using inappropriate body mechanics. Interverbal discs can also rupture or bulge with the application of a smaller amount of force usually in the context of the ageing process (‘wear and tear’) of the spine.
Signs & symptoms What tests are needed? How is it diagnosed? When surgery will be considered Surgical treatment

Signs & symptoms

In most cases symptoms will resolve spontaneously over about six weeks, although this depends on the size of the disc prolapse seen and surgery may be needed earlier. Neck pain can be accompanied with radicular symptoms which occurs due to nerve root compression (pressure on a spinal nerve).

Neck pain can be accompanied with cervical radiculopathy or cervical myelopathy which occurs due to spinal cord and nerve root compression (pressure on a spinal nerve). Signs and symptoms include:

  • Pain that radiates from the neck down the arm (brachalgia). Sometimes this pain can radiate into the fingertips or between the shoulder blades.
  • Sensation changes (paraesthesia)
  • Loss of bladder control
  • Progressive balance problems while walking
  • Weakness or motor deficit in upper and/or lower limbs
  • Loss of spinal reflexes.

What tests are needed?

Magnetic Resonance Imaging (MRI) and/or Computed Tomography (CT) will be performed when planning surgery to help confirm diagnosis, reveal the anatomy of the herniated disc, assess nerve root compression and identify the precise location of the effected disc level.

How is it diagnosed?

Diagnosis is made from the findings of the clinical examination, your symptoms and relevant tests.

When surgery will be considered

  • Surgery will be considered as the last resort when you have ongoing symptoms despite non-surgical treatment.
  • Significant pain that radiates down the arm (brachalgia)
  • Progressive balance problems while walking.
  • Sensation changes such as numbness or pins and needles (paraesthesia).

Surgical treatment

Mr Gomes performs a number of surgeries for cervical disc prolapse. This will be assessed and discussed at your consultation in order to choose which option is right for you.

  • Cervical Fusion/Arthroplasty – involves removal of the disc at the affected levels and permanently connecting two or more vertebrae in your spine. It is usually needed if there is severe disc degeneration associated with loss of height and/or subluxation (slippage between the vertebrae.)

  • Cervical Laminectomy +/- Screw fixation – removal of the bony roof surrounding the spinal canal to create more space for the spinal cord and nerves. This is generally considered when more than 3 spinal levels are affected and may require screw fixation.

For all appointments and enquiries, please phone   03 8318 4929

MAIN CONSULTING ROOMS

Mayfair Specialist Centre
Level 7
250 Victoria Parade
East Melbourne VIC 3002

ALSO CONSULTING AT

Knox Private Hospital
Suite 1A
262 Mountain Highway
Wantirna VIC 3151

Holmesglen Private Hospital
Suite A1
Paso Consulting Suites
490 South Road
Moorabbin VIC 3189

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