What Is Cervical Stenosis?
Spinal stenosis is a condition in which the spinal canal gradually narrows and squeezes the spinal cord and nerves. This is usually due to the common occurrence of degeneration that takes place with aging. Occasionally, it can be caused by intervertebral disc herniation, osteoporosis, or tumor. Some patients are born with a congenitally narrow spinal canal. Spinal stenosis may affect the cervical (neck), thoracic (upper back), or lumbar (low back) spine. In some cases, it may be present in all three places in the same patient. Narrowing of the spinal canal in the neck is called cervical stenosis.
Signs and Symptoms
Patients may experience:
- Neck pain which may not be severe
- Pain, weakness, and/or numbness in the shoulders, arms, and legs
- Difficulty or clumsiness with fine motor activities such as counting coins or buttoning shirts
- Gait and balance disturbances as if drunk
- Burning sensations, tingling, and pins and needles in the upper back, shoulder, arm, hand, and/or fingers
- Bowel and bladder problems in severe cases
- Complete or near complete loss of arm and leg function (quadriplegia) in rare but most severe cases
Dr. Cho performs a thorough examination during your initial visit that includes the following. He will ask you about your symptoms and their severity, what makes the symptoms better or worse, and what treatments you have already tried. A careful musculoskeletal and neurologic exam will consist of analyzing your gait and balance, arm and leg strength, sensation and reflexes, as well as special maneuvers to study certain neurologic function. Dr. Cho will often order x-rays, CT scans, and/or MRI of your neck and carefully review them with you.
There are a number of non-operative treatments that can help relieve symptoms. Being educated about healthy neck posture and proper body mechanics is important. Medications such as anti-inflammatories or muscle relaxants can alleviate the pain. Physical therapy along with aerobic exercises, bracing, or traction can decrease pain and increase function. Various modalities (cold/heat therapy for example) can be helpful. Epidural steroid injections or nerve root blocks may be recommended when there is a pinched nerve.
When non-operative treatments do not provide adequate relief of symptoms or there are signs of spinal cord compression, surgery is often recommended. The goal of surgery is to safely take the pressure off the spinal cord and nerve roots. Dr. Cho will offer the procedure that is best suited for you. The spine can be approached from either the front (anterior) or the back (posterior) of the neck.