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Cervical Stenosis

What is Cervical Stenosis?

Woman holding her neckCervical stenosis, also known as cervical spinal stenosis, is a progressive condition which results in spinal cord compression and pinching of the spinal cord in the neck. Stemming from the word ‘stenosis,’ which means ‘narrow,’ the spinal canal becomes too narrow for the spinal cord and nerve roots, causing the nerves exiting the spinal cord to compress or pinch, damage which is also known as myelopathy. The excess pressure in turn leads to swelling, pain, weakness, and even numbness in various parts of the body. Due to natural degenerative changes in the joints which tighten the spinal canal, this painful condition is more common among the elderly.

Symptoms of Cervical Stenosis

Individuals suffering from cervical spinal stenosis with myelopathy may experience one or more of the following symptoms:

  • Neck pain
  • Pain in one or both arms
  • Shooting pain in the arms and legs
  • Electrical sensation shooting down the back
  • Feeling like hands/arms are asleep
  • Weakness and numbness in the arms and legs
  • Heavy feeling in the legs/Difficulty walking
  • Loss of coordination and fine motor skill deterioration (i.e. ability to write, open a jar, turn a doorknob, or button a shirt)
  • Bladder and bowel function problems

Cervical Stenosis Causes

Cervical stenosis may develop from the following causes:

  • Naturally from old age
  • Disc degeneration (wear and tear)
  • Osteoarthritis
  • Previous injury/surgery

Cervical Stenosis Progression

It is important to note that cervical stenosis is a progressive disorder which may develop at a very slow or quick rate. When the condition is mild, people with cervical stenosis are often asymptomatic and do not seek treatment. As the condition progresses, however, so do the symptoms. While mild symptoms can be controlled via medication and physical therapy, surgery to decompress the affected area may be necessary if a critical level of spinal cord compression or a pinched neck occurs.

Cervical Stenosis Treatment

To help relieve neck and arm pain, non-operative treatments include the use of anti-inflammatory medications and analgesics to reduce swelling and inflammation. Epidural steroid injections or trigger point injections may also be prescribed for pain relief. Additional pain management strategies include:

  • Physical therapy
  • Activity modification
  • Neck and back exercises to increase strength, flexibility, and endurance

Surgery for Cervical Stenosis with Myelopathy

The goal of surgery for cervical stenosis is to decompress the spinal canal and arrest the progression of the condition. Depending where most of the compression or ‘stenosis’ is located, various types of surgery may be performed. In anterior cervical fusion, surgery is performed from the front. Disc and bone material causing the compression is removed and the spine stabilized through a bone graft (fusion) or via spinal hardware such as plates and screws. In posterior laminectomy, surgery is performed from the back of the neck, wherein the ligaments and bones compressing the spine are removed and the spine stabilized. Alternatively, the spinal cord may be expanded via a surgical procedure called laminaplasty.

Fortunately, most patients recover very quickly from cervical stenosis surgery, often going home within a few days. Pain and discomfort typically reduce within one or two weeks post surgery and individuals gradually resume normal activities.