Cervical Spinal Stenosis

Clinical symptoms of cervical spinal stenosis may include upper extremity weakness, numbness, pain, and loss of function, and also may cause gait or walking disturbance.  Mild forms of this problem exist and may present without significant symptoms while advanced forms may present with dramatic loss of function. However, the natural history of cervical stenosis and its clinical counterpart, cervical myelopathy, is one of slow worsening and loss of function over time, so it is important that the problem is identified properly. Other symptoms may include:

• Chronic neck pain that can radiate into the shoulders, and arms.
• A sensation of numbness, tingling or a pins and needles sensation in the hands, arms, legs, and feet.
• Weakness in the hands, arms, legs and feet.
• Balance problems, difficulty walking or maintaining balance, and an increased risk of falls.
• Problems with coordination, fine motor skills such as writing, typing, buttoning a shirt.
• Bladder and bowel dysfunction in severe cases.

If you are experiencing symptoms, early intervention and proper management can prevent further deterioration and improve your quality of life.

The most common cause is age-related degenerative changes, wear and tear, and osteoarthritis can cause the formation of bone spurs and thickening of the spinal ligaments which can narrow the canal. Early recognition and appropriate management are crucial to prevent long-term problems and improve your quality of life.

Common underlying causes of cervical stenosis and myelopathy include:

• Repetitive stress caused by certain occupations, sports, or heavy lifting increases the risk of cervical stenosis.
• Herniated cervical discs may bulge or rupture and protrude into the spinal canal, thereby compressing it.
• Trauma to the neck can cause swelling and displace tissues, contributing to stenosis.
• The inflammation of Rheumatoid Arthritis can lead to bone spurs and other changes that narrow the canal.
• Additionally, some people are born with a naturally narrow spinal canal, making it susceptible to additional narrowing from the above causes.

Dr. Colman will review your medical history, inquire about your symptoms and when they began, and perform a physical exam to evaluate your physical and neurological function.

He will order imaging studies, including X-rays to check for bone spurs and changes in spinal alignment. An MRI will provide detailed images of the spinal cord and nerves and help to identify the location of compression. A CT scan may be used when patients cannot have an MRI or to obtain more detail of the bony tissues.

Options depend on the severity of your symptoms and the underlying cause.

Mild cases can be treated with conservative nonsurgical management including:

NSAIDS anti-inflammatory medications, activity modification, posture improvement, and physical therapy. Epidural steroid injections can reduce inflammation and pain.

For more serious cases of compression and pain, surgery may be necessary to address the cause, such as bone spurs or herniated discs.

Surgical treatments include:

• Decompression surgery, such as a laminectomy or laminoplasty, to remove or reshape structures that are compressing the spinal cord and/or nerves.
• Anterior cervical decompression and fusion to decompress the spinal cord, stabilize and re-align the spine
• Anterior Total Disc Replacement decompresses the spinal cord and replaces the damaged disc with an artificial disc to maintain motion in the spine.

If you experience any of these symptoms, it is important to see an expert. Dr. Matthew Colman is an orthopedic expert who can determine the cause of your symptoms and recommend appropriate treatment options. It is important to note that early diagnosis and treatment can greatly reduce the severity of symptoms and improve the chances of recovery.