PROLAPSED CERVICAL IVD DISC

Monday, 21st May 2018

CERVICAL DISC PROLAPSE is not common compared to the lumbar disc prolapse. the site most prone to disc prolapse is the lower cervical spine particularly at C5-C6 level. The postero-lateral protrusion is common.

Incidence :

Occurs commonly in young adults and middle aged persons.

Causes: 

1) Injury to the neck due to sudden jurk or twisting strain

2) Over strain

 ONSET:

Patient present with an acute pain in neck radiating down the arm to tip of the fingers. symptoms

usually appear hours after the injury. The protrusion that results may be either of the following types:-

Mild protrusion: it caused localised pain and compression of the posterior longitudinal ligament.

Moderate protrusion: The disc herniates through the posterior ligament and presses laterally on the nerve root due to lateral cord compression.

Severe protrusion : there occurs central protrusion which compresses the spinal cord hence results into severe neurological complications.

FEATURES:

Stiffness of neck

Spasm of cervical muscles.

Renderness over C5,C6, or C7 spinous process

Limited cervical movements particularly flexion and extension

Pain worsens on coughing and sneezing.

Pain radiates down the shoulder upto the thumb through the lateral aspect of arm

Sometimes parasthesia may be felt in the hand.

Pain is relived when the arm is held in abduction with elbow flexed.

ONEXAMINATION:

Neurological examination is done to determine the level of prolape and the nerve root compressed.

       Usually the C5 nerve root gets compressed due to C5,C6 prolapse due to which there will be:

                   Diminished or absent biceps jerk

                   Weakness of biceps

                    Hypoaesthesia in outer border of forearm, thumb and index finger

Sometimes the C7 nerve root also gets compressed when there is C6-C7 disc prolapse which shows:

                    Reduced sensation in index and middle fingers

                    Weakness of triceps

                     Diminished or absent triceps jerk.


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