The intervertebral disc is a fibro cartelagenous disc situated in between the two adjacent vertebra. It has
Nucleus pulposus this is the central portion which is under pressure all the time.
Annulus fibrosus this is the fibrous tissue surrounding the nucleus pulposus and holding it in place.
The commonest site of spine where the disc prolapsed occurs is at the level of L4-L5 spine at the back and C5-C6 spine in the neck
L4-L5 disc prolapse cause
C5-C6 disc prolapse causes
Pain in the neck
Neck pain radiating to back of the arm
Neurological symptoms
Physical examination
Imaging
Myelogram – in this the contrast medium is injected into the spinal canal and sequential X-rays are taken. This is an invasive procedure and MRI has replaced the myelogram
Electromyogram and nerve conduction studies
Conservative treatment
The initial line of management is conservative and the usually the cervical disc prolapse responds well to the conservative line of management.
1. Rest
2. Analgesics
4. Weight reduction
5. Chiropractic
Surgical management
Surgical management is considered when the conservative line of management do not offer relief, when there is progressive deterioration in the neurological symptoms, presence of UMN or LMN type of paralysis.
Here the prolapsed, nucleus pulposus exerting pressure on the spinal cord or nerve root is removed, relieving pressure on the nerve.
Disc arthroplasty
Nucleoplasty