Surgery for a ruptured or herniated cervical disk is the most commonly performed surgical procedure for neck pain that usually includes pain radiating into an arm.

Anatomy

• The normal cervical spine is composed of seven building blocks called vertebrae (labeled C1 through C7) that sit on the thoracic (chest) spine (Figure 1)
  1. At the upper end of the cervical spine sits the head. The cervical spine allows one to bend the head forward (flex) and backward (extend) and tilt and twist the head to the left and right
  2. Each vertebrae is constructed of a body, lamina, and pedicles which surround an opening, the spinal canal (Figures 2 and 4)
  3. On each side of a cervical vertebra lie the facets, the portion of the vertebra that forms the joints between two vertebrae (Figure 3)
  4. Through the spinal canal passes the spinal cord. Nerve roots form at each level and exit the spine through holes (foramina) formed by two adjacent vertebrae. The spinal cord and the part of the nerve roots within the spinal canal are enclosed in a fibrous sac called the dura. The nerve roots eventually form into nerves that go to the arms
  5. The spinal cord and roots float in fluid (cerebrospinal fluid) and are contained within the dura
• Separating any two vertebral bodies is a soft elastic material called a disk. The disk is composed of two parts, a soft center called the nucleus and a tough outer band called the annulus
  1. Lining the surface of the disk space of the two vertebrae on top and bottom are thin plates of cartilage
  2. There are seven cervical disks beginning below C2 and extending below C7. There is no disk between C1 and C2

Figure 1 - Seven cervical vertebrae as seen from the front.	Figure 2 - Cervical vertebra and disk seen from below.