Cervical disc herniation is a common spinal problem with today’s society.  The condition itself has about as many different names as the number of people it affects.  Some of the common ones are disc bulge, slipped disc, disc protrusion, sequestered disc, disc prolapse, disc tear, etc.  In addition to the many different terms used to describe a cervical disc herniation, there are a variety of treatments available.  The treatments, however, are case-specific.  They vary depending on the severity of the disc injury, symptoms associated with it, and the effect on the peripheral or central nervous system.  

To determine what is the best treatment option, it is important that you understand the biomechanics associated with a spinal disc, and the process of a disc injury.  

First, let’s start off with the basics.  A spinal disc is located between two vertebral bodies.  It acts as a shock absorber between the vertebra above it and the vertebra below it.  The disc is circular with a viscous fluid center called the nucleus pulposus and an outer ring-shaped portion called the annular fibrosus, which is similar to the consistency of cartilage.  Envision that a disc’s inside is like jelly, and the outside is like a hard rubber.  

Now that you understand the anatomy of a disc, let’s talk about the disc injury.  Disc bulge happens when the outside “hard rubber” portion “bulges” out.  This bulge alters the normal shape of the disc from primarily circular, to circular with an additional semi-circular portion at a particular location.  As long as the outside “hard rubber” ring does not tear, the “jelly” material will stay contained within the disc.  However, if it does tear, it leads to a cervical disc herniation.  This is where the “jelly” actually leaks out slightly from the disc tear.  If the “jelly” leaks out and separates from the inner disc contents, then it is called a sequestered disc.  

Let’s review: there are three different primary disc injuries.  A disc bulge, a disc herniation, and a sequestered disc.  Each of them have varying degrees of complexity.  The primary reason is because the disc is located in close proximity to the central nervous system (i.e. spinal cord) and peripheral nervous system (i.e. nerve roots exiting the spinal column, sciatic nerve roots, etc.).  Because of the sensitivity of the surrounding nervous system, a disc injury can cause anything ranging from pain to actual muscle atrophy.  If the injured disc contacts or irritates a part of the nervous system, it must be addressed properly to determine the appropriate treatment.