At Home with Chris Jessen 2018 - 173
A slipped disc can lead to serious
spinal problems, but a full recovery
is possible if treated early
ost people are familiar with
slipped disc or sciatica arising
in the lower back and causing
severe leg pain. What is less
commonly understood, but can cause
greater disability, is slipped disc in
the cervical spine, or neck. Mr Ahmed
Ibrahim specialises in this condition.
Prolapsed or 'slipped' disc
Sudden-onset disc prolapse can be
caused by sudden movement or minor
trauma. However, a more common
cause of developing a disc prolapse is
age-related wear and tear. Genetic and
environmental factors play a role too,
but these remain poorly understood.
Disc prolapse can happen at any age,
but changes relating to wear and tear
often start in the 20s. By the sixth
decade of life, the majority of people
will have one or more disc prolapse, but
not all of them will have any symptoms.
Neck disc prolapse symptoms
There are two types of symptoms:
Neck and arm symptoms Prolapses
that affect the nerves of the neck cause
pain in the neck that can spread down
one or both arms to the fingers. There
may be numbness or tingling in the arms
and hands, too.
Spinal cord symptoms If a slipped
disc causes compression of the spinal
cord, it can result in serious
dysfunction of the spinal cord itself.
This manifests as numbness and
weakness in the hands and can lead to
dexterity problems, imbalance when
MEET THE EXPERT
Mr Ahmed Ibrahim,
MRCS (Ed) FRCS
(Neuro Surg) PhD,
is a consultant
a special interest
in treating spinal
as neck, arm and back pain, arm or leg
weakness, spinal tumors, slipped disc
and slipped vertebrae.
Mr Ibrahim completed medical training
at St Bartholomew's and the Royal
London Hospital and neurosurgical
training in North Thames, London. He
is lead consultant for spinal tumors
(metastatic spinal cord compression)
and is actively engaged in improving
treatment for spinal patients at
Queen's Hospital in Romford.
walking and bladder dysfunction. Left
untreated, it can lead to difficulty with
Investigation and treatment
Investigations include X-ray, CT scan,
MRI scan and neurophysiological tests.
Severe disc prolapses causing
compression of the nerve roots,
leading to constant pain that does
not respond to painkillers or
physiotherapy, may need surgical
intervention. Treated early, a full
recovery can be achieved.
Cervical spine surgery
There are various surgical options:
Disc replacement surgery (pictured)
This is an excellent option in younger
patients or those who are active and
wish to preserve neck motion.
Disc fusion surgery A discectomy
and fusion is a tried-and-tested approach.
The disc is removed and replaced with
an artificial cage that promotes fusion.
Posterior foraminotomy Those who have
pressure on one or two nerves without cord
compression may be ideal candidates for this
minimally invasive surgery. It relieves the
pressure on the nerves thereby reducing pain.
Laminectomy and cervical fusion When
multiple discs in the neck cause cord
compression, a good option is to
remove some of the bones in the back
of the spinal canal called the lamina.
This is often followed by cervical fusion.
Hospital stay is generally short and
the risk of complications is not high.
The vast majority of patients experience
excellent improvement of their symptoms.
In summary, if a patient experiences
pain, numbness, weakness or dexterity
issues, then consultation with a specialist is
necessary. Non-surgical treatment may be
advised initially, but surgical treatment may
be necessary and has excellent outcome.
FOR MORE INFORMATION
Yvonne Baillie 020 8347 3874
Jacqui Wright Email jacqueline.