Cervical Spinal Stenosis

Cervical Spinal Stenosis with Myelopathy and Radiculopathy

Cervical spinal stenosis refers to abnormal stenosis (narrowing) of the spinal canal that might result in neurological deficit. Common symptoms might include loss of motor control, pain, paraesthesia and numbness.

It is very common among people older than age 50 as it is often cause by age-related changes in the size and shape of the spinal canal. Because of aging the tissues that connect bones can thicken or there might happen a “bulging of the discs”. Aging is also responsible for excessive growth of the bones in joints and destruction of tissues that cover bones.

Cervical Spinal Stenosis symptoms

The symptoms are not visible until the nerves or the spinal cord is squeezed. Many people who have some narrowing of the spinal canal do not have the symptoms. That’s because most of the time the symptoms develop gradually over a pretty long period of time. The most common symptoms are numbness, stiffness, incontinence, coordination problems and weakness in the neck, arms or legs. Which part of the body is affected depends on the location of stenosis.

Because of the cervical spinal stenosis symptoms of radiculopathy and myelopathy can appear. The symptoms of myelopathy might include impaired walking, impaired finger and hand use as well as incontinence (dysfunctions of bladder and bowel). These symptoms should be taken very seriously because myelopathy might cause permanent damage of the nerve or the spinal cord if it is not treated.

Another common problem caused by cervical spinal stenosis is radiculopathy. It happens when because of cervical spinal stenosis there is pressure on nearby nerve roots. It could produce weakness, pain or sensory changes. The condition can affect an area starting from the cervical spine to the hand or shoulder.

More About The Diagnosis

The diagnosis is based on a physical exam and a history of symptoms. If neck movement causes pain, weakness or numbness cervical spinal stenosis might be suspected and the doctor might recommend imaging tests that might include MRI, X-rays and CT (computed tomography) scans or myelograms. The results of the tests will be used to rule other possible diagnosis like vitamin B12 deficiency or MS (multiple sclerosis).

In cases of severe cervical spinal stenosis surgery might be considered but many times it is detected before surgery is necessary. In case of cervical stenosis it’s necessary to ask for a specialist assistance of a neurologist who could make further recommendations for treatment.

The nonsurgical treatment should aim first to relieve pain and reduce inflammation. It might include NSAIDs (Nonsteroidal anti–inflammatory drugs) such as naproxen, ibuprofen, aspirin or indomethacin. Corticosteroid injections could also be used to reduce inflammations along with analgesics to reduce pain like acetaminophen as well as anesthetic injections.

The therapy could also include restricted activity, a corset or lumbar brace as well as physical therapy or prescribed exercises.

There are a few alternatives like acupuncture and chiropractic treatment. The philosophy behind the chiropractic treatment says that restricted movement in the spine causes the pain and reduces proper function.

In many cases the knife cannot be avoided and the people will have to resort to surgery. Surgery is recommended immediately in the cases when the patient has impaired bladder or bowel, weakness or numbness that interferes with walking or other neurological complications.

The surgery is meant to reduce pressure on the spinal cord and nerves and restore normal function. Usually this is done by removing, trimming or adjusting the diseased parts.