The six cervical intervertebral discs (C2-C3 through C7-T1) are fibrocartilaginous structures between adjacent cervical vertebral bodies, each consisting of a central nucleus pulposus and a surrounding annulus fibrosus. Cervical discs are proportionally thicker anteriorly, contributing to the normal cervical lordosis. The uncovertebral joints (Luschka joints) at the posterolateral disc margins are unique to the cervical spine and form part of the intervertebral foramen boundary.
Cervical disc herniation most commonly occurs at C5-C6 and C6-C7, producing radiculopathy or myelopathy depending on the direction of herniation. Posterolateral herniations compress nerve roots producing dermatomal pain and weakness, while central herniations compress the spinal cord. The proximity of the disc to the vertebral artery in its foramen transversarium means that severe disc-osteophyte complexes can occasionally compress the artery. Anterior cervical discectomy and fusion (ACDF) is the standard surgical treatment for symptomatic cervical disc disease.
Posterolateral herniation of the nucleus pulposus compresses the adjacent nerve root in the intervertebral foramen, producing dermatomal arm pain, paraesthesia, and weakness corresponding to the compressed root level, managed with physiotherapy, epidural injection, or ACDF when conservative measures fail.
Progressive cervical disc degeneration, osteophyte formation, and ligamentum flavum hypertrophy reduces the cervical spinal canal diameter and compresses the spinal cord, producing insidious upper and lower motor neurone signs including hand clumsiness, gait instability, and sphincter dysfunction requiring surgical decompression.
