What to Do for Cervical Disc Herniation

Cervical disc herniation is one of the more common spinal disorders encountered clinically, second only to lumbar disc herniation. Following degenerative changes of varying degrees, external factors may cause rupture of the annulus fibrosus, allowing the nucleus pulposus to protrude or extrude into the spinal canal. This results in compression of adjacent structures—such as spinal nerve roots and the spinal cord—leading to symptoms including headache and vertigo. There are two primary treatment approaches:

1. Non-surgical therapy, which includes traction, manual manipulation (tuina), physical therapy, exercise, nerve blockade, and pharmacotherapy. Among these, traction, manual manipulation, physical therapy, and exercise are the most commonly employed modalities. As each modality is indicated for different symptom profiles, their application should always be guided by a physician.

2. Surgical therapy, which comprises two main approaches: anterior cervical decompression and posterior cervical decompression. Anterior cervical decompression is typically indicated for patients with central or paracentral disc herniation and involves using a ring saw to perform decompression and remove the damaged intervertebral disc. Posterior cervical decompression is generally reserved for patients with lateral-type cervical disc herniation; in cases of isolated disc herniation, this approach entails direct removal of the disc tissue compressing the nerve root.