Cervical Disc Herniation Treatment New York City| Dr. Zeeshan Sardar

Dr. Zeeshan Sardar, MD, MSc, F.R.C.S.C
Director, Quality & Patient Safety (QPS) – Och Spine Hospital
Medical Director, Spine Unit – Och Spine Hospital
Co-Chief of Spinal Deformity Surgery • NewYork-Presbyterian / Columbia University
Och Spine Hospital • New York, NY

A cervical disc herniation occurs when the soft inner material of a disc in the neck ruptures through the outer wall and presses on a nerve root or the spinal cord. It is a common and often dramatic event — the onset of severe arm pain, numbness, or weakness can be alarming. The reassuring truth is that most cervical disc herniations improve significantly with non-surgical treatment. For those that do not, surgical options are safe, effective, and well-established.

WHAT IS A CERVICAL DISC HERNIATION?

Each cervical disc consists of a tough outer ring (the annulus fibrosus) surrounding a soft, gel-like core (the nucleus pulposus). A herniation occurs when the nucleus ruptures through a tear in the annulus and protrudes into the spinal canal or neural foramen. The extruded material compresses the adjacent nerve root (causing radiculopathy — arm pain and numbness) or, in more central herniations, the spinal cord itself (causing myelopathy — hand dysfunction, gait disturbance, and weakness). The most commonly herniated levels are C5–6 and C6–7.

SYMPTOMS

  • Neck pain — often the initial symptom, ranging from mild stiffness to severe pain
  • Arm pain (radiculopathy) — sharp, electric, or burning pain radiating from the neck into the shoulder, arm, or hand
  • Numbness and tingling — in a dermatomal pattern matching the compressed nerve root
  • Weakness — of specific muscles supplied by the compressed nerve root (e.g., grip, bicep, or tricep weakness)
  • Hand clumsiness or gait disturbance — if the herniation is central and compresses the spinal cord (myelopathy); warrants prompt surgical evaluation

DIAGNOSIS

MRI is the primary diagnostic study and provides detailed imaging of the herniated disc, nerve root or cord compression, and surrounding anatomy. CT or CT myelography provides better bony detail when needed. Electrodiagnostic studies can help confirm the level and distinguish cervical radiculopathy from peripheral nerve compression.

NON-SURGICAL TREATMENT

  • Physical therapy — the most important non-surgical treatment; cervical stabilization, posture training, and traction
  • Oral steroids or NSAIDs — for acute severe pain
  • Cervical epidural steroid injections — effective for acute radicular pain relief
  • Activity modification — avoiding positions that worsen nerve compression

WHEN IS SURGERY INDICATED?

  • Failure of conservative treatment after 6–12 weeks
  • Progressive neurological deficit — worsening weakness or expanding numbness
  • Myelopathy from central cord compression — surgery is generally recommended once moderate myelopathy is established
  • Intractable pain not responding to non-surgical measures

SURGICAL OPTIONS

  • ACDF — removes the herniated disc, decompresses the nerve or cord, fuses the level; the most commonly performed surgery for cervical disc herniation
  • Cervical disc replacement — for appropriately selected patients; removes the herniation, decompresses the nerve, preserves motion; FDA-approved for 1–2 level disease
  • Posterior cervical foraminotomy — a minimally invasive approach from behind; appropriate for soft lateral herniations without fusion

FREQUENTLY ASKED QUESTIONS

Will my herniated disc heal on its own?

Herniated disc material can shrink and the surrounding inflammation can resolve over time in many patients, which is why conservative treatment is the first step for most people.

How do I know if it’s an emergency?

New or rapidly worsening weakness, significant hand clumsiness, or gait and balance changes warrant prompt evaluation, since these can indicate spinal cord involvement rather than a nerve root alone.

Can physical therapy make it worse?

Appropriately directed physical therapy is generally safe and helpful. A program specifically designed for cervical disc herniation, rather than generic neck exercises, is preferred.

Do I need an MRI right away?

Not necessarily for mild symptoms managed conservatively, but an MRI is recommended for significant pain, neurological symptoms, or symptoms that don’t improve within a few weeks.

What’s the difference between this and cervical radiculopathy?

Disc herniation refers to the underlying structural problem; radiculopathy refers to the symptoms (pain, numbness, weakness) it causes by compressing a nerve root. The two terms are closely related but not identical.

WHY CHOOSE DR. SARDAR

Dr. Sardar offers the full spectrum of treatment options for cervical disc herniation and is equally expert in ACDF, disc replacement, and posterior foraminotomy. He evaluates each patient individually and recommends the approach best suited to their anatomy, symptoms, and goals.

This page is for educational purposes only and does not constitute individualized medical advice.

RELATED CONDITIONS & PROCEDURES

To schedule a consultation, call 212-932-5187 or visit the contact page.