Cervical Spinal Stenosis

 

What is cervical spinal stenosis?

Cervical spinal stenosis is the narrowing of the spinal canal in the neck, which is the open area in the bones (vertebrae) that make up the spinal column. The spinal cord is a collection of nerves that runs through the spinal canal from the base of the brain to the lower back. These nerves allow us to feel, to move, and to control the bowel and bladder and other body functions. In cervical spinal stenosis, the spinal canal narrows and can squeeze and compress the nerve roots where they leave the spinal cord or it may compress or damage the spinal cord itself. The seven vertebrae between the head and the chest make up the cervical spine. Squeezing the nerves and cord in the cervical spine can change how the spinal cord functions and cause pain, stiffness, numbness, or weakness in the neck, arms, and legs. It can also affect your control of your bowels and bladder.

What causes cervical spinal stenosis?

Cervical spinal stenosis is usually caused by age-related changes in the shape and size of the spinal canal and so is most common in people older than age 50. The aging process can cause a "bulging of the discs"—the spongy discs between the bones of the spine bulge out farther than normal—or a thickening of tissues that connect bones (ligaments). Aging can also lead to destruction of tissues that cover bones (cartilage) and excessive growth of the bones in joints. These conditions can narrow the spinal canal (spinal stenosis).

What are the symptoms?

While many people older than age 50 have some narrowing of the spinal canal, they don’t all experience symptoms. Symptoms only occur when the spinal cord becomes squeezed. Symptoms usually develop gradually over a long period of time and may include: Stiffness, pain, numbness, or weakness in the neck, shoulders, arms, hands, or legs. It can also cause loss of bowel or bladder control as well as balance and coordination problems, such as shuffling or tripping while walking. Cervical spinal stenosis can be crippling if the spinal cord is damaged.

How is cervical spinal stenosis diagnosed?

We will review your medical history and ask you if neck movements cause pain, numbness, or weakness. If cervical spinal stenosis is suspected, we will most likely recommend imaging tests of your neck and back to confirm the diagnosis and to see what is causing the narrowing of the spinal canal. Imaging tests that may be used include X-raysMRI and/or CT scans. We will use the results of these tests, as well as blood tests, to eliminate other diseases, such as multiple sclerosis (MS) and vitamin B12 deficiency, as the cause of your symptoms.

How is it treated?

In mild cases of spinal stenosis, symptoms can usually be controlled with medicine to relieve pain and exercise and physical therapy to maintain strength and flexibility. If your symptoms are severe, you have progressive weakness of your muscles, or the pictures of your spine show that your spinal cord or nerves are being tightly squeezed, we may recommend decompressive surgery to relieve the pressure. This surgery may be done from the front or the back of the neck. It involves removing some of the disc, bone, and/or tissue that may be pressing on the nerve roots. Vertebrae are often surgically fused to provide stability to the spine.

It is important to note that cervical spinal stenosis can potentially cause serious problems with the nervous system, including problems with bowel or bladder control and permanent loss of strength and feeling in the arms, hands, and legs. We will not wait for you to have severe symptoms of pain, weakness, and numbness before considering treatment to relieve pressure on your spinal cord and nerves. 

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