Cervical Disc Herniation (Neck Hernia)
A cervical disc herniation occurs when a disc in the neck region protrudes and compresses a nerve root or the spinal cord. It is most common at the C5-C6 and C6-C7 levels and typically causes pain radiating into the arm, with numbness and weakness.
最終更新: 2026-06-06
Definition
A cervical disc herniation is displacement of the nucleus of an intervertebral disc in the neck through the outer annulus toward the spinal canal or the nerve-root canal (foramen). Because the cervical spine is mobile and adjacent to the spinal cord, compression may affect the nerve root (radiculopathy) and/or the spinal cord (myelopathy).
Causes and Risk Factors
Age-related disc degeneration is the principal cause. Prolonged forward-flexed head posture (screen and phone use), repetitive strain, acute neck trauma and genetic predisposition increase risk. Cervical spondylosis frequently coexists.
Symptoms
Typical features are pain radiating from the neck into the shoulder and arm, dermatomal numbness or tingling, and muscle weakness. When the spinal cord is compressed (myelopathy), reduced hand dexterity, gait imbalance and leg spasticity may develop; these findings require further evaluation.
Diagnosis
Assessment begins with a neurological examination, dermatomal sensory-motor-reflex testing and provocative tests such as the Spurling test. Magnetic resonance imaging (MRI) best demonstrates the relationship of the disc to the nerve root and spinal cord. Computed tomography (CT) is complementary for evaluating bony structures and osteophytes.
Treatment
Many patients with radiculopathy improve with conservative care (brief rest, analgesic and anti-inflammatory medication, physical therapy, posture correction). Surgery is considered for refractory pain or progressive deficit. Surgical options include anterior cervical discectomy and fusion (ACDF) and disc arthroplasty; surgery may take priority when myelopathy is present.
Prognosis
Most patients with radiculopathy improve with conservative treatment, whereas signs of spinal cord compression may warrant early surgical evaluation. Outcomes depend on the patient, the level of compression and the presence of myelopathy.
参考文献
- Greenberg MS. Greenberg's Handbook of Neurosurgery. 10th ed. Thieme; 2023:1280-1294.
- Winn HR, ed. Youmans Neurological Surgery. 6th ed. Saunders; 2011.
- North American Spine Society (NASS) — Diagnosis and Treatment of Cervical Radiculopathy from Degenerative Disorders.
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