Each intervertebral disc has two main parts:
- A soft, gel-like center called the nucleus pulposus
- A stronger outer ring called the annulus fibrosus
Healthy discs help distribute pressure across the spine and allow for spine movement.
Please review the Cervical spine anatomy section for more information.
With aging, repetitive stress, injury, or genetic factors, a disc may lose water content, become thinner, develop small tears, or extend beyond its normal boundaries.
Because the spinal cord and cervical nerve roots are located close to the discs, disc disorders can sometimes affect the nervous system. Below are some of the ways this can happen.
Major Diagnosis Types
Below are the major types we see in our clinic. Click on available links to learn about our approach to the problems.
Degenerative Disc Disease
Cervical degenerative disc disease is the gradual wearing and aging of one or more discs in the neck.
Despite its name, degenerative disc disease is not always a true disease. Disc degeneration is a common part of aging. Many people have degenerative changes on an MRI without experiencing pain.
Degenerative disc disease may cause chronic neck pain, stiffness, or pain that spreads into the arm. It may also contribute to spinal stenosis or instability.
Disc Herniation
A cervical disc herniation occurs when material from the center of the disc pushes through a weakened or torn area in the outer disc wall.
The herniated material can cause inflammation or directly compress a nearby nerve root. A large central disc herniation can sometimes place pressure on the spinal cord.
Minor Diagnosis Types
These terms are often encountered, but are either less often treated or described within one of the above diagnoses.
Annular Tear
A cervical annular tear is a crack or separation within the annulus fibrosus, the outer wall of the disc.
Annular tears may occur because of aging, repetitive stress, or injury. Some tears cause no symptoms. Others may produce localized neck pain because the outer portion of the disc contains sensitive nerve fibers.
Disc Bulge
A cervical disc bulge occurs when the outer portion of the disc extends beyond its normal position over a relatively broad area.
Disc bulges are common and do not always cause symptoms.
The importance of a disc bulge depends on the patient’s symptoms, neurologic examination, and imaging findings. An MRI finding by itself does not always identify the source of pain.