Clinical Case Study: Cervical Disc Herniation with Arm Numbness and Weakness

Diagnostic Findings

She was first evaluated by a neurosurgeon, who arranged X-ray and MRI imaging of the cervical spine. Imaging confirmed a disc herniation at the C5-C6 level, with the protruding disc material compressing the adjacent nerve root — the degree of disc protrusion was assessed at approximately 50%, consistent with her right thumb numbness and arm weakness.

When she was referred to me after her neurosurgical consultation, I agreed that surgery did not need to be the first step. At around 50% disc protrusion, this was a case where nerve compression could reasonably be addressed through a less invasive route before considering open surgery. I discussed both a traditional open surgical decompression and a minimally invasive laser-based option with her, including the trade-offs of each — open surgery carries a higher published success rate, but a minimally invasive approach carries lower procedural risk and avoids a visible surgical scar. Given her presentation and the moderate degree of disc protrusion, I felt it was reasonable to offer her the minimally invasive option first.

Treatment Approach

After we discussed the options, she chose to proceed with percutaneous laser disc decompression (laser nucleoplasty). I carried out the procedure as follows:

1. Under imaging guidance, I inserted a laser probe percutaneously into the affected disc at the C5-C6 level.
2. I used the laser to ablate a portion of the nucleus pulposus (the disc’s inner core material), reducing the internal pressure within the disc.
3. This reduction in pressure created a vacuum effect that drew the herniated disc material back away from the compressed nerve root.
4. I then used a catheter to gently dilate the narrowed portion of the spinal canal at the affected level, creating additional space around the nerve.
5. Following the procedure, I prescribed a course of medication and referred her for a period of physiotherapy to support her recovery.

Outcome

In this case, the patient’s numbness and associated swelling sensation had reduced by approximately 80% within the first month after treatment, and had resolved by two months post-procedure. The weakness in her right arm and hand recovered over the following two to three months. At her last follow-up, she reported being free of her presenting pain, no longer required medication, and had resumed activities requiring fine hand dexterity and grip strength, continuing the daily exercises recommended by her physiotherapist to maintain function.

This outcome reflects one individual case. Treatment suitability and results depend on each patient’s specific diagnosis and clinical assessment.

Ask the Doctor

Q: Can a herniated disc in the neck cause numbness and weakness in the hand, and does it always need surgery?

A: Yes — a herniated disc in the neck, most commonly at the C5-C6 or C6-C7 level, can compress the nerve root that supplies sensation and strength to the arm and hand, causing exactly this pattern of numbness and weakness. It doesn’t always require open surgery as the first step. When the degree of disc protrusion is moderate, as it was in this case, a minimally invasive option such as percutaneous laser disc decompression can relieve the nerve compression with a lower procedural risk and no visible scarring, though patients should understand its success rate is generally lower than that of open surgical decompression. The right approach depends on the severity of compression, how long symptoms have been present, and the patient’s own risk tolerance, which is why I discuss both options rather than defaulting to one.

Related Reading

• Slipped Disc Singapore: Causes, Symptoms and Diagnosis
• Slipped Disc Treatment Without Surgery: Minimally Invasive Options Explained
• Neck Pain Treatment in Singapore
• Neck Pain Specialist Singapore