Acute Events that Lead to Cervical Disc Herniation Causing Radiculopathy-A Study in a Tertiary Care Centre in Eastern India

BACKGROUND Cervical disc prolapse causing radiculopathy is one of the most common disorders treated by both neurologists and spine surgeons. Herniation of disc most commonly occurs in those below the age of 45 years. Pain appears in the neck and radiates towards the arms or vice versa i.e. arises in the arm and radiates to the neck. With aging and other risk factors, nucleus pulposus of cervical intervertebral disc show degeneration or dehydration. This disc may rupture through the posterior annulus fibrosus into the spinal canal or into the neural foramen compressing the exiting nerve root. Acute events can produce disc prolapse in those susceptible individuals who are already having degenerated disc. METHODS The study includes patients attending the OPD or those admitted in the Neurology and Neurosurgery Department of Calcutta National Medical College and Hospital with symptoms of cervical radiculopathy. The study period was from 01.03.2018 to 28.02.2019. Inclusion criteria of the study were radicular pain with or without sensory or motor signs with MRI evidence of root compression, electrophysiologic evidence of cervical radiculopathy when MRI was contraindicated or noncontributory and symptoms onset was within the last 3 months. RESULTS In this retrospective descriptive study, acute events noted within 48 hours that lead to cervical disc herniation are road traffic accidents in 27.9%. of the cases, lifting heavy objects accounted for 16.1% of the cases, violence and assault accounted for 11.7% of the cases, fall accounted for 10.3% of the cases, repetitive strain accounted for 10.3% of cases, Sports & recreation accounted for 7.3% of the cases, falling objects accounted for 4.4% of the cases and no obvious cause (idiopathic) accounted for 11.7% of the cases. 77.9% of the cases of cervical disc prolapse occurred in persons below 49 years of age. In this series, incidence of cervical disc prolapse was higher in males 69.1%. CONCLUSIONS There is a need for increasing awareness among both the medical and general population about the acute events that can cause cervical disc herniation so that necessary precautions taken and lifestyle modifications be done to maintain cervical spine health.