Cervical Disc Herniation: Symptoms and Treatment Options

Q: Cervical Disc Herniation: Symptoms and Treatment Options

Hello： 1. <br>Nerve compression in the cervical spine rarely presents with unilateral symptoms (rare, but not absent). <br>2. <br>MRI shows nerve compression at cervical levels 5-6 and 6-7, particularly pronounced at 5-6. <br>If conservative treatment does not yield satisfactory

Cervical intervertebral disc herniation

I would like to ask about my condition.
I have been experiencing pain and numbness between my left index finger and thumb for an entire day, along with pain in the outer upper arm.
I often feel a sensation like an electric shock extending from my upper arm to my fingers, which has lasted for about a month.
Recently, I visited a hospital and had an MRI of my cervical spine.
However, in the past few days, I have started to feel a slight tingling sensation in my right foot, particularly in the sole and around the ankle or big toe.
It hasn't progressed to numbness yet, but it has been almost constant for the past three to four days.

Could a herniated cervical disc cause tingling or numbness in the lower limb, such as the foot? Based on the two images provided, which vertebrae appear to be compressed? Is there an urgent need for surgery? If I choose to pay out of pocket for surgery, can I opt for an artificial disc replacement for just one vertebra?

Wang, 40~49 year old female. Ask Date: 2023/08/06

Dr. Lai Zhaokang reply Neurosurgery

Hello: 1.
Nerve compression in the cervical spine rarely presents with unilateral symptoms (rare, but not absent).
2.
MRI shows nerve compression at cervical levels 5-6 and 6-7, particularly pronounced at 5-6.
If conservative treatment does not yield satisfactory results, it meets the criteria for surgery.
Whether to operate on one segment at a time or two segments at once will require a closer examination of the MRI details in conjunction with your actual symptoms.
Wishing you a speedy recovery.
By Dr.
Lai Chao-Kang, Chief of Spine Surgery, Changhua Hospital.

Reply Date: 2023/08/06

More Info

Cervical disc herniation is a condition that occurs when the soft inner material of a cervical disc protrudes through the tougher exterior, potentially compressing nearby nerves or the spinal cord. This can lead to a variety of symptoms, including pain, numbness, tingling, and weakness in the arms and hands, as well as in some cases, the legs and feet. The symptoms you are experiencing, such as pain and tingling in your left hand and now in your right foot, suggest that there may be nerve involvement due to cervical disc issues.

The symptoms you describe, particularly the electric shock-like sensations radiating from your upper arm to your fingers, are indicative of cervical radiculopathy. This occurs when a nerve root in the cervical spine is compressed or irritated, often due to herniated discs or degenerative changes in the spine. The fact that you are now experiencing sensations in your right foot could suggest that the issue may not be limited to the cervical region, or it could indicate a more complex pattern of nerve involvement.

To address your questions regarding the potential for cervical disc herniation to affect the lower limbs: while it is less common for cervical issues to directly cause symptoms in the legs, it is possible if there is significant compression of the spinal cord or if there are issues further down the spine, such as lumbar disc herniation. The cervical spine primarily affects the upper extremities, but if there is a broader neurological issue, it could manifest as symptoms in the lower extremities.

Regarding the MRI findings, without seeing the images, it is challenging to determine the exact level of compression or the need for surgical intervention. Typically, surgery is considered when conservative treatments (such as physical therapy, medications, and injections) fail to alleviate symptoms, or if there is significant weakness, loss of function, or progressive neurological deficits. The decision to proceed with surgery, such as a discectomy or artificial disc replacement, would depend on the severity of the symptoms, the degree of nerve compression, and the overall health of the patient.

If you are considering surgery, it is important to discuss the options with a qualified spine surgeon. They can evaluate your MRI results and clinical symptoms to determine if surgery is necessary and what type of procedure would be most appropriate. In some cases, it may be possible to perform a targeted surgery on a single level of the cervical spine, but this decision will be based on the specific findings from your imaging studies and your overall clinical picture.

In summary, cervical disc herniation can lead to a range of symptoms, and while it primarily affects the upper extremities, it can also influence the lower limbs under certain conditions. A thorough evaluation by a specialist, including a review of your MRI and a detailed neurological examination, is essential to determine the best course of action for your situation. If conservative treatments have not provided relief, surgical options may be worth exploring, but this should be done in consultation with your healthcare provider.

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