What it is
Each cervical disc sits between two vertebrae and acts as a shock absorber. When the outer ring (annulus fibrosus) weakens or tears, the inner gel-like nucleus can protrude or herniate into the spinal canal or neural foramen, compressing a nerve root or, in central herniations, the spinal cord itself.
Cervical disc herniation is common, particularly at C5-6 and C6-7, and tends to occur in adults in their 30s to 50s. Many herniations occur with minimal trauma or gradually with cumulative wear.
Natural history
The majority of cervical disc herniations improve over 6–12 weeks with conservative management. Disc material undergoes a natural resorption process, particularly with soft herniations, and nerve root inflammation resolves. Surgery is not the default response to a cervical disc herniation on MRI — it is reserved for patients who fail a genuine trial of non-operative care or who present with progressive neurological deficits that make waiting inappropriate.
When surgery is considered
Surgery is appropriate when:
- Arm pain, weakness, or numbness persists despite 6–12 weeks of appropriate conservative management
- There is progressive motor weakness in the arm
- Signs of spinal cord compression (myelopathy) are present
The procedure — typically ACDF or cervical disc arthroplasty — removes the disc and decompresses the nerve. Results for carefully selected patients are generally very good.