Cervical disc herniation
Nerve & spinal cord compression in the neck
SFCR Patient Sheet: Download the patient information leaflet (PDF)
What is a cervical disc herniation?
Just as in the lumbar spine, the cervical vertebrae are separated by intervertebral discs that act as shock absorbers. When one of these discs tears and part of its contents protrudes, it can compress a nerve (nerve root) or, in more severe cases, the spinal cord itself.
The cervical spine is special in two ways: first, the nerves that pass through it control the arms and hands; second, the spinal cord runs through the cervical canal, which means any cord compression is potentially more serious than at the lumbar level. The most commonly affected levels are C5-C6 and C6-C7.
How it develops
A cervical herniation results from the same processes as a lumbar one, adapted to the biomechanics of the neck:
• Disc wear: natural degeneration of the disc weakens the fibrous ring
• Mechanical stresses: repetitive neck movements, prolonged screen work, sustained "head forward" postures
• Triggering event: sometimes a trauma (whiplash, contact sport), but often no specific event
• Predisposing factors: smoking accelerates disc degeneration, including at the cervical level
Symptoms & Clinical signs
The clinical picture depends on which structure is compressed — nerve or spinal cord:
Nerve root compression (cervicobrachial neuralgia)
• Arm pain: pain radiating from the neck into the shoulder, arm and sometimes the fingers — the "sciatica of the arm"
• Tingling: in specific fingers depending on the root involved (thumb and index for C6, middle finger for C7)
• Weakness: biceps, triceps or grip weakness depending on the level
Spinal cord compression (myelopathy)
• Loss of dexterity: clumsiness of the hands, difficulty writing or buttoning
• Gait disturbance: "stiff" legs, loss of balance
• Relative urgency: any cord compression requires prompt neurosurgical assessment
Diagnosis
• Clinical examination: Spurling's test (pressure on the head with lateral tilt reproduces the arm pain); search for cord signs
• Cervical MRI (gold standard): visualises the herniation, its relationship with the nerve and cord, and detects any cord "signal change"
• CT scan: details the bony anatomy, useful if MRI is contraindicated or before surgery
• EMG: measures nerve suffering and helps identify the affected root in doubtful cases
Treatment
As with lumbar herniations, the majority of cervical disc herniations resolve without surgery:
Conservative treatment (first line)
• Relative rest, soft cervical collar for a short period if needed
• Anti-inflammatory drugs and painkillers to control acute pain
• Cervical physiotherapy once the acute phase has passed: gentle mobilisation, muscle strengthening
• Cervical injections: foraminal or epidural, performed under imaging guidance
Surgical treatment
• Indications: pain resistant to medical treatment, neurological deficit (weakness), signs of cord compression
• Anterior cervical discectomy and fusion (ACDF): the most classic technique — the disc is removed from the front of the neck and replaced by a cage that fuses the vertebrae
• Cervical disc replacement: an alternative in selected younger patients, preserving mobility of the operated segment
• Outcome: success rate above 90% for arm pain relief
Key figures
80%
Spontaneous improvement within 2 months without surgery
C5-C6 / C6-C7
Most commonly affected levels
15%
Of the population has an asymptomatic cervical herniation on MRI
Recovery after surgery
Anterior cervical surgery as performed by Dr Dimitriu offers a swift recovery:
• Day of surgery: the patient gets up the same evening. Arm pain is often relieved immediately upon waking
• Hospital stay: 1 to 3 nights depending on the procedure (fusion or disc replacement)
• First weeks: mild difficulty swallowing and slight hoarseness are common but temporary (a few days). A soft cervical collar may be prescribed for comfort
• 4 to 6 weeks: gradual return to daily and professional activities. Gentle cervical physiotherapy begins
• 3 months: follow-up imaging to check fusion (arthrodesis) or proper positioning of the prosthesis
• 6 months: full return to sport for most patients
Consultation with Dr Dimitriu
A specialist in cervical spine surgery, Dr Dimitriu carries out a thorough clinical examination at the first consultation: Spurling's test, assessment of arm and hand muscle strength, and search for signs of cord compromise. He reviews your imaging (cervical MRI, CT scan) to identify the exact level and type of compression.
Each patient receives personalised care. Dr Dimitriu clearly explains the different treatment options — medical management, injections or surgery — and guides you through the decision with complete transparency.
Prevention
• Workstation ergonomics: screen at eye level, use a headset for phone calls, take regular breaks to move the neck
• Cervical strengthening: gentle isometric exercises to stabilise the neck muscles
• Posture: avoid "text neck" (head bent over a smartphone) which overloads the cervical discs
• Stop smoking: smoking accelerates cervical disc degeneration
Consultations in Île-de-France
Dr Dimitriu practises at 4 facilities in the Paris region (Île-de-France), easily accessible from central Paris: Clinique de l'Yvette (Longjumeau), Hôpital Privé d'Antony, Clinique du Mont-Louis (Les Lilas) and Hôpital Privé de l'Ouest Parisien (Saint-Cloud). See addresses and book an appointment.
Frequently asked questions
The choice depends on age, the level involved and the condition of adjacent joints. A disc replacement preserves mobility and is preferred in younger patients with a single affected level. Fusion is preferred for multiple levels, advanced arthritis or instability. Dr Dimitriu discusses both options with each patient.
Anterior cervical surgery is well-established with a low complication rate. The main risks include temporary difficulty swallowing, transient hoarseness, and very rarely nerve injury. The success rate for arm pain relief exceeds 90%.
On average, 4 to 6 weeks for office work and 8 to 12 weeks for physical work. Driving is usually resumed after 3 to 4 weeks. Dr Dimitriu adapts these timelines to each individual situation.
Post-operative pain is generally moderate and well controlled with painkillers. Most patients report mild throat discomfort that resolves within days. The arm pain is often relieved immediately upon waking.
Sources: SFCR · Spine Journal (Radhakrishnan et al.) · HAS.