What is Cervical Spinal Stenosis?
Cervical spinal stenosis refers to the narrowing of the spinal canal. The spinal canal houses the spinal cord, the bundle of nerve fibers that connect the brain with the peripheral nervous system. Narrowing of the spinal canal often results from degenerative changes in the spine associated with aging.
One common cause is a bone spur that forms, extends into the spinal cord, and presses on the nerves in the spinal canal or directly on the spinal cord itself. Disc problems can also lead to cervical spinal stenosis. A ruptured disc in the cervical spine can compress the spinal cord and cause it to narrow. If a cervical vertebra is not lined up properly with its neighbor—a condition called spondylolisthesis—the vertebra can slip out of alignment and put pressure on the nerves or the spinal cord.
Some people are born with a spinal canal that is too narrow. Over time, degenerative changes can cause more narrowing, putting additional pressure on the spinal cord.
Other causes of cervical spinal stenosis are injuries that involve a vertebra or ligament breaking and impinging on the spinal cord. Less commonly, tumors can grow inside the spinal canal and cause it to narrow.
Who is at Risk? People born with a congenitally narrow spinal canal are more likely to develop cervical spinal stenosis. The elderly are at greater risk because they may have experienced degenerative changes such as bone spurs and ruptured discs that narrow and put pressure on the spinal cord. Trauma can play a role, also. A significant number of people with cervical spinal stenosis have a history of a neck injury years prior to the onset of stenosis.
Since cervical spinal stenosis puts pressure on the spinal cord rather than a single nerve root, it can cause symptoms involving both the arms and legs. Common indicators include numbness or weakness in the shoulders, arms, or legs. Neck pain may be present, though it may not be the most prominent symptom. In fact, people with cervical spinal stenosis may not realize the problem is in their neck if the symptoms are localized in other parts of the body.
Cervical spinal stenosis can cause clumsiness, balance problems, and erratic leg movements that make it difficult to walk. In more severe cases, bowel or bladder problems can develop.
Diagnosis begins with a thorough physical exam including an X-ray of the cervical spine to look for problems such as tumors or fractures that can cause narrowing of the spinal canal. This is usually followed by a more advanced imaging study. An MRI is the best choice because it can show if the spinal cord is compressed and where the narrowing is located. It can also show damage to discs in the cervical spine, softening of the spinal cord (myelomalacia), or other problems within the spinal cord itself.
Medications to reduce inflammation and pain combined with physical therapy may help in mild cases of cervical spinal stenosis. Epidural steroid injections are another option for relieving pain, but they will not reverse the physical compression of the spinal cord. If the symptoms do not respond to conservative therapy, surgery to take pressure off the spinal cord and create more space within the spinal canal may be warranted. If the symptoms are severe, immediate surgery may be unavoidable.
Tom Wascher M.D. will review your imaging studies free of charge or, if needed, provide you with a second opinion. He has performed over 1,800 cervical surgeries during his career and wants to see that you receive the best treatment possible. He is a competent and caring surgeon who has your best interests in mind.