Cervical Stenosis

Cervical stenosis refers to narrowing of the spinal canal in the neck region. This narrowing exerts pressure over the spinal cord resulting in neck pain. Cervical spinal stenosis occurs due to the narrowing of the spinal canal or the neuroforamen, in the neck region. Central canal stenosis occurs if the spinal canal is narrowed and foraminal spinal stenosis occurs due to constriction of the neuroforamen, on either side of the vertebrae.

Causes

Cervical stenosis is most common in people above 50 years of age, as a consequence of aging and wear and tear of the spine. However, some patients are born with a narrow spinal canal (congenital cervical stenosis). Cervical stenosis may also result from an injury or trauma to the neck; however trauma might have occurred months or years before the onset of the symptoms of stenosis. The common conditions that may cause spinal cord compression include bone spurs (osteophytes), ruptured discs, degenerative disc disease, and thickening of spinal ligaments.

Symptoms

Some individuals with cervical spinal stenosis may not experience any symptoms; however the symptoms may develop gradually and deteriorate over time. The predominant symptom of cervical stenosis is mild to intense neck pain that may radiate to the arms, shoulders and hands. Other symptoms include problems with gait and balance, clumsy hand coordination, upper extremity pain and weakness, numbness, tingling, pins and needles sensation, bladder and bowel problems, and rarely loss of function (paraplegia).

Cervical stenosis may result in myelopathy, a spinal cord dysfunction that occurs due to the compression of the spinal cord in the neck, which can result from trauma. Myelopathy often develops suddenly or gradually and is characterized by neck pain, arm pain, weakness, and rarely paralysis.

Diagnosis

A diagnosis of cervical spinal stenosis is usually based on your medical history along with a physical and neurological examination. During physical examination your doctor will evaluate your muscle strength, reflexes, and sensations. Your doctor may order various tests such as X-rays, CT scans, MRI scan or myelography to determine the compression of nerves.

Treatment

Treatment of cervical spinal stenosis comprises of non-surgical and surgical treatment options. Non-surgical treatment of cervical spinal stenosis can help reduce pain and the associated symptoms. The non–surgical treatment options include anti-inflammatory and pain medications, muscle relaxants, physical therapy, spinal injections, certain types of braces, traction, and acupuncture. Your doctor may combine two or more treatment modalities to increase the success of the treatment.

Surgery is usually considered for patients with spinal instability or neurological dysfunction and persistent pain not responding to conservative treatment. The aim of the surgery is to relieve the pressure over the nerves or spinal cord. There are several surgical procedures for cervical spinal stenosis performed using minimally invasive techniques. Surgery involves removing or trimming parts of bone or soft tissue causing compression. The common surgical techniques include:

• Decompressive laminectomy: It is a surgical procedure in which a portion of the bone or lamina causing pressure on the nerves is removed.
• Laminoplasty: It is a surgical procedure performed to expand the size of the spinal canal and release pressure over the spinal cord and nerve roots.
• Discectomy: It is a surgical procedure performed for the removal of a herniated or ruptured disc from the affected region.
• Foraminotomy: It is a surgical procedure performed to widen the neuroforamen to relieve pressure on nerves that are being compressed.
• Instrumentation and fusion: Spinal Fusion is a surgical technique in which two or more vertebrae are joined with the help of bone grafts and/or instrumentation. Spinal instrumentation is a method of stabilizing the spine after fusion with the help of implants such as rods, plates, screws, and interbody devices. <

Your surgeon will discuss surgical options as well as the associated risks and benefits and recommend the most appropriate procedure for you. Your doctor is a reliable resource to answer all your questions and help you understand the condition better.