{"id":"0a395da1-58d6-485e-b30f-585af0af7178","slug":"nursing-review-section-of-surgical-neurology-international-evaluation-of-cervical-disc-disease-and-when-surgery-is-warranted","title":"Nursing review section of surgical neurology international: Evaluation of cervical disc disease and when surgery is warranted","authors":["Nancy E. Epstein","Renee D. Hollingsworth"],"abstract":"Background: Patients with cervical disc disease may present with radiculopathy (root compression), myelopathy (cord compression), or myeloradiculopathy. These complaints must be correlated with x-ray, magnetic resonance (MR) imaging, and computed tomographic (CT) scans. Although most patients can be managed nonsurgically, those with significant neurological deficits and larger disc herniations may require surgery. Methods: The symptoms of cervical radiculopathy include pain radiating down one or both arms, while myelopathy may result in more diffuse numbness tingling or weakness in the upper and/or lower extremities. The neurological signs for cervical discs include; focal or diffuse loss of motor strength changes in reflexes (hyporeflexic, normal reflexes, or hyperreflexia), a loss of sensation (e.g., to pin, vibration, touch, and position), and cerebellar dysfunction (e.g., loss of coordination). Patients’ symptoms and signs must correlate with focal nerve root and/or spinal cord compression seen on MR and/or CT studies. Results: MR examinations best document soft disc herniations, while CT scans most readily demonstrate calcification/ossification of cervical discs and accompanying arthritic changes. Bulging/protruding can typically be managed nonsurgically. Alternatively, significantly extruded or sequestrated discs, resulting in moderate/marked spinal cord and/or nerve root compression may warrant surgery. Most operations from front of the neck for cervical discs are called anterior cervical discectomy/fusion (ACDF), while those performed from the back of the neck are called laminoforaminotomies. Conclusion: Patients with cervical radiculopathy (root compression) and/or myelopathy (cord compression) with disc herniations on MR/CT studies may or may not require surgery.","thumbnailUrl":"https://sni-digital-videos.s3.amazonaws.com/articles/0a395da1-58d6-485e-b30f-585af0af7178/featured/hero-1782420912622.png","publishDate":"2017-07-07T00:00:00.000Z","doi":"10.4103/sni.sni_182_17","categories":["General Neurosurgery","Review Article"],"fullTextUrl":"https://surgicalneurologyint.com/api/articles/0a395da1-58d6-485e-b30f-585af0af7178/pdf"}