What are the subtypes of cervical disc herniation?

  Cervical disc degeneration itself and its secondary changes that irritate or compress the adjacent tissues and cause various symptoms and signs. Due to the development and progress of society, the way people work has changed dramatically and the number of desk-bound workers has increased dramatically, making the incidence of cervical disc herniation rise continuously.  Typology: According to the location of the cervical disc protrusion into the spinal canal, it can be divided into the following three types: 1. Lateral protrusion type: The protrusion site is on the lateral side of the posterior longitudinal ligament and the medial side of the hook vertebral joint. This is where the cervical spinal nerve passes through, so the herniated disc can compress the spinal nerve root and produce radicular symptoms; 2. Paracentral herniation: the herniated part is on one side and between the spinal cord and the spinal nerve, so it can compress both and produce unilateral spinal cord and nerve root symptoms; 3.  Clinical manifestations vary according to the location of cervical disc protrusion into the spinal canal: (1) Lateral protrusion type: unilateral radicular symptoms due to irritation or compression of cervical spinal nerve roots. In mild cases, there is numbness in the cervical spinal nerve innervation area (i.e., the upper limb of the affected side), and in severe cases, there is severe pain in the innervation area of the affected nerve segment, such as cutting or burning, accompanied by pins-and-needles or over-electricity-like tingling sensation, and the pain may be aggravated by coughing. In addition, there are painful slanting neck, muscle spasm and limitation of neck movement, as well as sinking and weakness of upper limbs, loss of grip strength and falling objects. Physical examination may reveal that passive movement of the neck or pressure from the head downward in the longitudinal direction may cause increased pain, changes in movement, sensation and reflexes of the involved nerve segments, and loss of muscle strength and muscle atrophy in the innervated area. In addition to the manifestations of the lateral protrusion type, symptoms of unilateral spinal cord compression may also appear to varying degrees, manifesting as increased muscle tone, decreased muscle strength, hyperactive tendon reflexes, decreased superficial reflexes, and pathological reflexes in the ipsilateral limb below the level of the lesion, and tactile and deep sensory deficits may appear; on the contralateral side, sensory deficits are predominant, i.e., temperature and nociceptive deficits, and the distribution of sensory deficits is not consistent with the level of the lesion, and the lesion (3) Central protrusion type: This type has no symptoms of cervical spinal nerve involvement and shows bilateral spinal cord compression. In the early stage, the symptoms are mainly sensory disorders or motor disorders, and in the late stage, the symptoms are incomplete spastic paralysis with different degrees of upper motor neuron or nerve bundle damage, such as clumsy gait, inactivity, unstable walking, often with a feeling of chest and lumbar girdle, and in severe cases, bed-ridden, or even difficulty in breathing, incontinence of bowels and urine. The examination shows increased muscle tone, decreased muscle strength, hyperactive tendon reflexes, decreased or absent superficial reflexes, positive pathological reflexes, positive patellar clonus and ankle clonus.