Pathophysiology, diagnosis, and management of cervical disc herniation

Cervical disc herniation is a common cause of neck pain and neurologic symptoms with presentations ranging from asymptomatic to debilitating radiculopathy or myelopathy. Symptoms may arise when a vertebral disc herniates, causing inflammation and compression of the nerve root or spinal cord. Risk factors are multifactorial and including age, genetics, cardiometabolic and behavioral factors, occupational biomechanics, and trauma. Accurate diagnosis requires patient history, neurological findings, provocative maneuvers, and imaging. The majority of cases improve with nonsurgical care including medication, physical therapy, and activity modification. Surgical evaluation is indicated for cases involving myelopathy, progressive neurologic deficits, or chronic/treatment-refractory symptoms.