XU HƯỚNG ĐIỀU TRỊ PHẪU THUẬT
THOÁT VỊ ĐĨA ĐỆM LỐI TRƯỚC
TS BS. LÊ VIẾT THẮNG
BỘ MÔN NGOẠI THẦN KINH
KHOA Y – ĐHYD TPHCM
1/ Conservative vs surgery treatment
2/ Arthroplasty vs Fusion
3/ Anterior vs Posterior
4/ Hydrid technique for MCM
CONCEPT
Cervical disc herniation is the result of the displacement of the nucleus pulposus of the
intervertebral disc.
Cervical Herniated Disc Causes:
- Disc degeneration over time.
- Trauma
Symptoms:
- Cervical radiculopathy
- Cervical myelopathy
MANAGEMENT
Conservative Treatments (75 to 90%) will improve.
Collar Immobilization: acute neck pain, a short course (approximately one week) of
collar immobilization.
Traction: approximately 8 to 12 lbs of traction at an angle (24 degrees-15 to 20
minutes).
Pharmacotherapy: There is no evidence to demonstrate the efficacy of non-
steroidal anti-inflammatories (NSAIDs) in the treatment of cervical radiculopathy.
Physical Therapy: is recommended in the absence of myelopathy.
Cervical Manipulation: There is limited evidence suggesting that cervical manipulation may
provide short-term benefits for neck pain and cervicogenic headaches. Complications from
manipulation are rare and can include worsening radiculopathy, myelopathy, spinal cord
injury, and vertebral artery injury.
Interventional Treatments: Spinal steroid injections are a common alternative to surgery.
Perineural injections (translaminar and transforaminal epidurals, selective nerve root
blocks) are an option with pathological confirmation by MRI. These procedures should take
place under radiologic guidance.