Orthopedics Book


Acute Cervical Disc Herniation

Aka: Acute Cervical Disc Herniation, Soft Cervical Disc Protrusion
  1. See Also
    1. Cervical Disc Disease
  2. Mechanism
    1. Nucleus pulposus bulges posterolaterally
      1. Annulus fibrosus weakest posterolaterally
      2. Posterior longitudinal ligament also weak
    2. Characteristics
      1. Acute disorder in younger patients
      2. Acute disc rupture leads to immediate radiculopathy
  3. Causes
    1. Cervical compression
    2. Axial loading
    3. Hyperflexion
  4. Symptoms
    1. See Cervical Disc Disease
  5. Signs
    1. See Cervical Disc Disease
  6. Management: General
    1. Cervical Collar
    2. Cervical Traction
    3. NSAIDs
    4. Muscle relaxers (usually not helpful)
    5. Physical Therapy
  7. Management: Return to participation
    1. Requirements to return to Contact Sports
      1. Healed anterior or lateral disc Herniation
      2. Discectomy and interbody solid fusion
        1. Lateral or central Herniation
        2. Neurologically intact
        3. Painless Range of Motion
    2. Relative Contraindications to Contact Sports
      1. Residual facet instability
    3. Absolute contraindications to Contact Sports
      1. Acute Central DIsc Herniations
      2. Neurologic deficit
      3. Pain or limited range of motion
      4. Spinal stenosis

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