A common cause of
, especially in older patients,
. Cervical stenosis is a
narrowing of the spinal canal in the neck
area or upper part of the spine. This
narrowing places pressure on the spinal
cord. While some patients are born with this
narrowing, most cases of cervical stenosis
occur to patients over the age of 50 and are
the result of aging and “wear
and tear” on the spine
If you are interested in relief from
cervical stenosis, please
to determine what treatment
option is best for you, what your insurance
will cover and any additional surgery costs.
Many patients with cervical stenosis have a
history of some kind of injury or trauma to
the neck, however this trauma may have
occurred many months or even years before
the onset of stenosis symptoms.
Symptoms of Cervical Stenosis
The symptoms of cervical spinal stenosis may
include the following:
- Neck pain; not always severe.
- Pain, weakness, or numbness in the
shoulders, arms, and legs.
- Hand clumsiness.
- Gait and balance disturbances.
- Burning sensations, tingling, and
pins and needles in the involved
extremity, such as the arm or leg.
- In severe cases, bladder and bowel
- Although rare, severe cases can also
cause significant loss of function or
Diagnosis of Cervical Stenosis
Good treatment is always based on an
accurate diagnosis. The comprehensive
diagnostic process includes:
- Medical history. Your doctor
will talk to you about your symptoms,
how severe they are, and what treatments
you have already tried.
- Physical examination. You
will be carefully examined for
limitations of movement, problems with
balance, and pain. During this exam, the
doctor will also look for loss of
reflexes in the extremities, muscle
weakness, loss of sensation or other
signs of spinal cord damage.
- Diagnostic tests. Generally,
doctors start with plain x-rays, which
enable them to rule out other problems
tumors and infections. CT scans and
MRIs give three-dimensional views of the
cervical spine and can help detect
osteophytes (bony growths) and
herniated discs. Occasionally
doctors use a myelogram. This is a test
that involves injecting liquid contrast
dye into the spinal column to show where
the spinal cord pressure is occurring.
Non - Operative Treatment
Most cases of cervical stenosis are
successfully treated with non-surgical
techniques such as pain and
anti-inflammatory medications. Depending on
the extent of nerve involvement, some
patients may need to temporarily restrict
their activities and wear a cervical collar
or neck brace for a time. However, most
patients only need to rest for a brief time.
Physical therapy exercises will also be
prescribed to help strengthen and stabilize
the neck as well as build endurance and
If non-surgical measures do not work, your
doctor may recommend surgery to treat your
stenosis. There are a number of surgical
techniques that can be used to treat this
condition. The goal of each of these
surgical decompression treatments is to
widen the spinal canal and relieve the
pressure on the spinal cord by removing or
trimming whatever is causing the
compression. However, since all surgical
procedures carry a certain amount of risk,
your doctor will discuss all of your options
with you before deciding which procedure is
best for you.
The most common surgery for
cervical stenosis is called a
decompressive laminectomy in which the
laminae (roof) of the vertebrae are removed,
creating more space in the spinal canal for
the nerves. If only a portion of the laminae
need to be removed, it is called a
Your surgeon may also consider performing
posterior laminoplasty. This technique
helps to retain spinal stability while also
expanding the spinal canal.
If there are any
herniated or bulging discs, these may
also be removed (this is called a
discectomy) to increase canal space.
Sometimes the foramen (the area where the
nerve roots exit the spinal canal) also need
to be enlarged. This procedure is called a
For those patients who need surgical
repair on more than one level or who have
significant spinal instability,
spinal fusion may be done in addition to
the decompression surgery. This involves
taking a small piece of bone (usually from
the hip) and
grafting it onto the spine. Spinal
hardware (called instrumentation) such as
plates and screws are used to support the
spine and provide additional stability. In
most cases, we can determine ahead of time
if fusion surgery is necessary. If it is,
the specialists at United Spine & Joint
will discuss this with you so that you are
aware of what is being done.
Recovery from Cervical Stenosis
Most patients can begin getting out of bed
on the same day surgery is performed!
Activity is gradually increased and patients
are typically able to go home within a few
days after their procedure, depending on the
extent of the surgery. As with most
surgeries, there will be some pain after the
procedure. However, doctors have pain
medications available that will help keep
you comfortable. The
physicians at United Spine & Joint take
pain management very seriously!
At home, you will need to continue to
rest. You will be instructed on how to
gradually increase your activity. You may
still need to take the pain medications for
a while. However, pain and discomfort should
begin to reduce within a week or two after
surgery. Other techniques for reducing pain
and increasing flexibility will be discussed
with you before you leave for home. When you
can return to work and other activities such
as sports and driving will also be discussed
with you by your doctor.