Tratamento conservador de hérnia discal cervical: relato de caso

Abstract

Introduction: Cervical disc herniation (CDH) has a high prevalence and negative impacts on the quality of life of patients. Symptoms include neck pain, which radiates to the upper limbs, resulting from mechanical compression and inflammatory activity of the herniated disc over the spinal cord and its nerves. Conservative treatment is the first therapeutic option and among its possibilities are foraminal infiltrations with corticosteroids and anesthetics. Objective: To present the case of a patient with CDH refractory to analgesics and non-steroidal anti-inflammatory drugs submitted to conservative treatment using foraminal infiltrations. Methods: Individual descriptive study of the case report type of a female patient, 33 years old, with neck pain for eight years and evolution to cervicobrachialgia. She had already used non steroidal anti-inflammatory drugs, common analgesics, weak opioids associated with antidepressants, and motor rehabilitation with no effective pain relief. Images of the cervical spine showed left protruding, posterolateral, and foraminal disc herniation between the C6 and C7 vertebrae, with compression of the emerging C7 root. Conservative treatment was proposed, with two sessions of foraminal blocks with an interval of two weeks, using lidocaine, betamethasone, and clonidine. Results: After the blocks, the patient presented complete remission of symptoms, evolving with a significant improvement in her quality of life. Conclusion: Neck pain caused by HDC is a common event in clinical practice and negatively impacts the quality of life of patients. Conservative treatment with cervical injections of corticosteroids and anesthetics is a viable and effective treatment option in selected cases.