{"title":"[颈椎间盘突出症:症状学、诊断学、治疗学]。","authors":"Dorothea Daentzer, Bastian Welke, Ahmed Baseem Ismail, Jannik Daentzer, Jochen Plagge","doi":"10.1007/s00132-024-04582-8","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Although herniated discs in the cervical spine are rare overall, patients with this clinical picture regularly present themselves in orthopedic and neurosurgical practice. Initially, those affected often have severe local and predominantly radicular pain and, optionally, dermatome-related neurological deficits in the upper extremities, with medullary signs occasionally being found.</p><p><strong>Prognosis: </strong>The prognosis for complete remission is usually favorable, so that primary therapy is almost always conservative. Based on guidelines, the relative and absolute indications for surgery can be derived depending on pain symptoms and neurological deficits.</p><p><strong>Surgical treatment: </strong>There are various surgical procedures to choose from. The ventral approach to the cervical spine with either insertion of a cage and the goal of fusion or implantation of an intervertebral disc prosthesis as arthroplasty is most often chosen. For lateral disc prolapse, dorsal foraminotomy with sequestrectomy is recommended. The postoperative outcome is predominantly positive with a relatively low complication rate.</p>","PeriodicalId":74375,"journal":{"name":"Orthopadie (Heidelberg, Germany)","volume":" ","pages":"26-39"},"PeriodicalIF":0.0000,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"[Cervical disc herniation : Symptomatology, diagnostics, therapy].\",\"authors\":\"Dorothea Daentzer, Bastian Welke, Ahmed Baseem Ismail, Jannik Daentzer, Jochen Plagge\",\"doi\":\"10.1007/s00132-024-04582-8\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Although herniated discs in the cervical spine are rare overall, patients with this clinical picture regularly present themselves in orthopedic and neurosurgical practice. Initially, those affected often have severe local and predominantly radicular pain and, optionally, dermatome-related neurological deficits in the upper extremities, with medullary signs occasionally being found.</p><p><strong>Prognosis: </strong>The prognosis for complete remission is usually favorable, so that primary therapy is almost always conservative. Based on guidelines, the relative and absolute indications for surgery can be derived depending on pain symptoms and neurological deficits.</p><p><strong>Surgical treatment: </strong>There are various surgical procedures to choose from. The ventral approach to the cervical spine with either insertion of a cage and the goal of fusion or implantation of an intervertebral disc prosthesis as arthroplasty is most often chosen. For lateral disc prolapse, dorsal foraminotomy with sequestrectomy is recommended. The postoperative outcome is predominantly positive with a relatively low complication rate.</p>\",\"PeriodicalId\":74375,\"journal\":{\"name\":\"Orthopadie (Heidelberg, Germany)\",\"volume\":\" \",\"pages\":\"26-39\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2025-01-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Orthopadie (Heidelberg, Germany)\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1007/s00132-024-04582-8\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2024/11/19 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Orthopadie (Heidelberg, Germany)","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1007/s00132-024-04582-8","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/11/19 0:00:00","PubModel":"Epub","JCR":"","JCRName":"","Score":null,"Total":0}
Background: Although herniated discs in the cervical spine are rare overall, patients with this clinical picture regularly present themselves in orthopedic and neurosurgical practice. Initially, those affected often have severe local and predominantly radicular pain and, optionally, dermatome-related neurological deficits in the upper extremities, with medullary signs occasionally being found.
Prognosis: The prognosis for complete remission is usually favorable, so that primary therapy is almost always conservative. Based on guidelines, the relative and absolute indications for surgery can be derived depending on pain symptoms and neurological deficits.
Surgical treatment: There are various surgical procedures to choose from. The ventral approach to the cervical spine with either insertion of a cage and the goal of fusion or implantation of an intervertebral disc prosthesis as arthroplasty is most often chosen. For lateral disc prolapse, dorsal foraminotomy with sequestrectomy is recommended. The postoperative outcome is predominantly positive with a relatively low complication rate.