My Spine - Cervical
How is it treated?
There are always four options:
o treatment – This is acceptable if there is no serious nerve compression -
therefore in the absence of spasticity or muscle weakness. There is a certain
proportion of patients who will get better without an operation within the first
six to twelve weeks after onset of the first symptoms.
on-invasive treatment – The initial treatment for a cervical disc herniation
is conservative treatment that might include anti-inflammatory medication,
analgesic medication, physiotherapy and other manual treatments such as chi-
ropractic treatment, pressure point therapy, massage therapy, traction and
other therapies. This would usually be followed for a period of at least six
weeks.
Semi-invasive treatment – These include procedures like radiofrequency
rhizotomy (see the chapter Cervical Radiofrequency Rhizotomy) for the treat-
ment of facet joint mediated mechanical neck pain and Nucleoplasty (see the
chapter Cervical ucleoplasty) for the treatment of discogenic pain. These
treatments may be highly effective, have very few side effects or complica-
tions and are performed as day procedures. These procedures have a very def-
inite place in the non-surgical management of cervical disc disease.
If conservative management is unsuccessful, then surgery is usually indicat-
ed. In situations where there is muscle loss or sensation loss due to a com-
pressed nerve, surgery is considered much sooner. Compression that contin-
ues for too long can cause permanent nerve damage. The longer the duration
of the symptoms, the smaller the chance of success when operating to decom-
press the nerves.
Invasive (surgery) – The indications for surgery are:
1. Failed conservative management. This would include the use of analgesic
medication, anti-inflammatory medication, physiotherapy and chiropractic
treatment for a period of at least six weeks before surgery is contemplated.
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