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 Risk Factors for Cervical Disc Herniation

Rick C. Sasso, MD
Orthopaedic Surgeon and President
Indiana Spine Group
Indianapolis, IN, USA
Vincent Traynelis, MD
Professor of Neurosurgery
University of Iowa
Iowa City, IA, USA
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Progressive Steps Toward a Cervical Disc Herniation
Many factors increase the risk for disc herniation: (1) lifestyle choices such as tobacco use, lack of regular exercise, and inadequate nutrition substantially contribute to poor disc health. (2) As the body ages, natural biochemical changes cause discs to gradually dry out affecting disc strength and resiliency. (3) Poor posture combined with the habitual use of incorrect body mechanics can place additional stress on the cervical spine.

Combine these factors with the effects from daily wear and tear, injury, incorrect lifting, or twisting and it is easy to understand why a disc may herniate. A herniation may develop suddenly or gradually over weeks or months.

The four stages to a herniated disc include:

  1. Disc Degeneration: chemical changes associated with aging causes discs to weaken, but without a herniation.

  2. Prolapse: the form or position of the disc changes with some slight impingement into the spinal canal. Also called a bulge or protrusion.

  3. Extrusion: the gel-like nucleus pulposus breaks through the tire-like wall (annulus fibrosus) but remains within the disc.

  4. Sequestration or Sequestered Disc: the nucleus pulposus breaks through the annulus fibrosus and lies outside the disc in the spinal canal (HNP).

disc disorders

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Article written 08/05/2001
Published online 08/05/2001
Last updated 05/18/2007

Doctors Sasso and Traynelis describe the basic anatomy and natural history of cervical degenerative spine disease. This is an excellent article that emphasizes the role of lifestyle in the degenerative cascade and overall high success rates with conservative therapy. They are to be commended on synthesizing a very informative, succinct article that covers a very broad topic about a common problem.

Mark R. McLaughlin, MD

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