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Cervical disc sequestration is a more advanced and often more problematic form of disc herniation, where a portion of the disc nucleus pulposus (the soft inner core of the intervertebral disc) becomes completely detached and migrates away from the original disc space. This can lead to more severe symptoms and complications compared to a contained disc herniation. Clinical Presentation: • Acute Onset: Symptoms often arise suddenly, especially if the sequestrated fragment compresses a nerve root or the spinal cord. • Radiculopathy: This is characterised by sharp, shooting pain that radiates from the neck into the shoulder, arm, and possibly the hand, depending on which nerve root is affected. Numbness, tingling, and muscle weakness may also occur. • Myelopathy: If the spinal cord is compressed, it can lead to more serious symptoms, including gait disturbances, loss of fine motor skills, and difficulty with balance and coordination. In severe cases, bowel and bladder dysfunction may develop. • Pain: Neck pain can be severe and may worsen with certain movements or positions. Treatment options for cervical disc sequestration typically begin with conservative approaches, including medications like NSAIDs for pain relief, physiotherapy to improve mobility and strengthen the neck muscles, and epidural steroid injections to reduce inflammation around the affected nerves. If these methods fail to alleviate symptoms or if there is significant nerve or spinal cord compression, surgical intervention may be necessary. Common surgical procedures include anterior cervical discectomy and fusion (ACDF), where the herniated disc is removed and the vertebrae are fused, or cervical disc replacement, which preserves more neck mobility.
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