[Cervical and thoracic disc herniation]

In principle, vertebral disc degeneration can occur in any segment of the spine. Epidemiological studies show that 36% of cases occur in the cervical spine, 2% in the thoracic spine and 62% in the lumbar spine. Different symptoms occur depending on the region of the herniated disc (HD). Radicular pain caused by a cervical herniated disc radiates segmentally into the arms (brachialgia), thoracic herniated discs radiate into the thorax (intercostal neuralgia), whereby physicians should be aware that not every herniated disc causes symptoms and approximately 50% of herniated discs are recognized as incidental findings in imaging but are asymptomatic. In the case of herniated discs the medical history and clinical examination are of great importance; it is always necessary to pay careful attention to so-called red flags. Herniated discs lose up to 40% of their volume during the course of the disease. This means that a significant percentage of patients experience a spontaneous improvement in pain and mild neurological deficits. Most HDs can be treated conservatively.