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Cervical foraminal stenosis, sometimes called a pinched nerve in the neck, is the narrowing of the foramen, the small tunnel through which nerve roots exit the spinal column. Each neck vertebra has a foramen on each side, and when a foramen becomes too narrow, it results in pressure on the nerve root, causing neck and arm pain, numbness, and weakness. Narrowing usually occurs on only one side of a vertebra, leading to symptoms in only one shoulder or arm, though less commonly, stenosis on both sides can cause bilateral symptoms. At Wascher Cervical Spine Institute in Appleton, WI, Dr. Thomas Wascher has achieved a 99% improvement rate, treating over 252 cases.
Foraminal narrowing is most commonly caused by degenerative changes or wear and tear associated with aging. As a person ages, bone spurs can form where a nerve root exits the cervical foramen, thus compressing the nerve as it passes through.
This narrowing of the foramen can also be caused by a herniated or bulging disc that decreases the size of the passageway, squeezing the nerve roots in the process. Certain congenital problems may predispose a person to cervical foraminal stenosis.
Common Symptoms: Cervical foraminal stenosis typically causes neck and arm pain that radiates into the shoulder blade, shoulder, and down the arm. It can also cause numbness, tingling, and weakness in the arms or hands due to pressure on the nerve roots. Because foraminal narrowing usually occurs on one side, symptoms typically affect only one shoulder or arm.
The neck pain and stiffness usually develop slowly over many years and may come and go. It can be worsened by certain activities or by holding the neck in certain positions. Some people live with this condition for years, attributing it to a strained neck. When the narrowing progresses and puts excessive pressure on the nerve roots, symptoms such as numbness, tingling, and weakness may develop.
Diagnostic Process: A physical exam is always the first step in diagnosis. Examination of the neck, plus a neurological exam, can pinpoint which nerve roots are being compressed. X-rays are often performed to identify problems such as bone spurs or instability that may be compressing the cervical foramen. This is typically followed by an MRI study of the neck. If the MRI does not identify the problem, a CT scan combined with a myelogram may be necessary.
Conservative Management: Anti-inflammatory medications and physical therapy or cervical traction may offer relief, especially when symptoms are mild. These conservative treatments are typically tried first.
Interventional Treatments: A nerve root block may be helpful in more advanced cases. This involves injecting a numbing medication and a steroid into the area where the nerve leaves the spinal column. An epidural injection of steroid medication into the area around the spinal cord may also temporarily relieve symptoms.
Surgical Options: When symptoms fail to improve with conservative measures, surgery may be an option. Posterior cervical (keyhole) foraminotomy is the primary surgical approach for cervical foraminal stenosis, involving enlargement of the foramen to relieve pressure on the nerve root. Alternatively, an anterior cervical discectomy may be performed if a herniated disc is the primary cause. Each approach aims to create more room for the nerve root to pass through the narrowed foramen. Fortunately, most people respond well to surgery for cervical foraminal stenosis.
Vanessa had years of neck pain leaving her unable to even do her daily work. But with Dr. Wascher’s quick and timely intervention that included multiple viewings of MRIs, muscle and nerve tests, followed by a 3-Level Anterior Cervical Fusion, she is now happy without any neck issues. “I can happily say that by following the recommendations of Dr. Wascher, I am now pain-free,” says Vanessa as she talks about how great Dr. Wascher and his team were to work with.
When Nanette experienced deep pain in her shoulder, she got tests performed, only to discover that she, in fact, had issues with her neck instead. After a few MRIs and scans, she contacted Dr. Wascher, who told her that she has bone spurs going into the spinal cord. Within a span of 3 weeks, she was able to go through surgery and get on the road to recovery. “I cannot say enough about Dr. Wascher’s expertise and empathy”, says Nanette as she joins an ever-growing community of people who, through Dr. Wascher and his team, have found happiness again.
Dr. Thomas Wascher brings over 30 years of specialized cervical spine expertise to the treatment of cervical foraminal stenosis. He has performed over 4,500 cervical spine surgeries during his career, with over 252 anterior-posterior cases treating foraminal stenosis, achieving a 99% improvement rate. Dr. Wascher's microscopic surgical techniques result in smaller scars, less pain, and faster recovery.
The practice offers free MRI reviews and second opinions at 5320 W. Michaels Dr., Appleton. Dr. Wascher graduated valedictorian from high school, college, and medical school and has been recognized as one of America's Top Surgeons since 2007.
Cervical foraminal stenosis involves the narrowing of the foramen where nerve roots exit, typically causing one-sided arm symptoms. Cervical stenosis involves the narrowing of the central spinal canal where the spinal cord passes, typically causing symptoms in both arms and legs.
Cervical foraminal stenosis is often a progressive degenerative condition that develops slowly over years. The pace varies among individuals. Conservative management and activity modifications may help slow progression.
Nerve root blocks and epidural steroid injections can provide temporary symptom relief. While they don't address the underlying narrowing, they can reduce inflammation and pain for weeks to months.
Most people respond well to surgery. At Wascher Cervical Spine Institute, Dr. Wascher has achieved a 99% improvement rate. Surgery creates more space for the compressed nerve root, often providing significant relief.
Posterior cervical foraminotomy is a minimally invasive procedure that enlarges the foramen to relieve nerve compression. It preserves motion and typically has a faster recovery compared to fusion procedures.