Cervical Spinal Stenosis
Cervical spinal stenosis is a narrowing of the spinal canal in the neck area or upper part of the spine. At CalSpine MD, our spine surgeon, Dr. Ball, treats cervical spinal stenosis frequently, as it is a very common cause of neck pain. The cervical spine (neck region) consists of seven bones, separated from one another by intravertebral discs. The top of the cervical spine connects to the skull, and the bottom connects to the upper back at about the shoulder level. If you are diagnosed with cervical spinal stenosis, Dr. Ball will work with you to find a treatment option that works best for you, whether it involves surgery or nonsurgical methods.
Causes of Cervical Spinal Stenosis
Spinal stenosis most often develops due to degenerative changes in the spine, such as with osteoarthritis or degeneration. These changes can narrow the spinal canal, eventually putting pressure on the spinal cord and/or nerve roots. Disc herniations can also cause spinal stenosis.
Degenerative spinal stenosis is very common. By the age of 50, 95 percent of people will experience degenerative changes in the spine. However, not everyone experiences symptoms.
Other causes of cervical spinal stenosis include
- Disc Herniation(s)
- Narrow Spinal Canal (Congenital/developmental, or present from birth)
- Injury or Trauma to the Neck
- Spinal Tumor
- Certain Bone Diseases
- Past Surgery of the Spine
- Rheumatoid Arthritis
Symptoms of Cervical Spinal Stenosis
Symptoms of cervical spinal stenosis include
- Neck Pain
- Pain, Weakness, or Numbness in the Shoulders, Arms, and Legs
- Hand Clumsiness
- Gait and Balance Disturbances
- Burning Sensations, Tingling, and Pins and Needles Feeling in the Arms or Legs
In severe cases, spinal stenosis can cause loss of bladder or bowel control. If you experience this, seek immediate medical attention.
Cervical Spinal Stenosis Diagnosed
To diagnose cervical spinal stenosis, Dr. Ball will ask you about your symptoms and do a complete physical exam, looking for signs of spinal stenosis, such as limitation of movement, problems with balance, pain, loss of reflexes in the extremities, muscle weakness, loss of sensation or other signs of spinal cord damage. Dr. Ball may also order X-rays of your cervical spine to rule out other problems, such as kyphosis or instability. An MRI scan may be ordered for a three-dimensional view of the cervical spine soft tissues such as the spinal cord, discs and ligaments. Additionally, a myelogram may be ordered for patients who cannot have an MRI. For a myelogram, a CT scan is taken after injecting dye into the spinal column to show where the spinal cord pressure is occurring.
Treatments for Cervical Spinal Stenosis
At CalSpine MD, Dr. Ball offers a full range of nonsurgical and surgical treatment options for cervical spinal stenosis.
Nonsurgical Treatment for Cervical Spinal Stenosis. Nonsurgical treatment for cervical spinal stenosis may include the following:
Anti-inflammatory Medications. These help to decrease pain and inflammation of the nerve roots.
Cervical Collar or Neck Brace. Patients wear these on a temporary basis to restrict movement and activity in an effort to reduce their pain.
Physical therapy. Helps to improve strength, stabilize the neck, build endurance, and increase flexibility. This may or may not include traction.
If an extended period of nonsurgical treatment does not improve symptoms, surgery may be considered.
Surgical Treatment for Cervical Spinal Stenosis. At CalSpine MD, Dr. Ball offers a few different surgical approaches for cervical spinal stenosis. He will review the options with you to help you choose what is best for your lifestyle and current condition.
Decompression Laminectomy. This is the most common surgical procedure for cervical spinal stenosis. During this procedure, Dr. Ball will remove any bone, bone spurs, or ligaments that are putting pressure on the nerves. The back part of the vertebra, called the lamina, is also partially removed, creating more space in the spinal canal for the nerves.
Discectomy. A discectomy is done to remove any herniated or bulging discs to increase canal space.
Foraminotomy. Sometimes the foramen, the area where the nerve roots exit the spinal cord, need to be enlarged.
Laminotomy. Similar to a laminectomy, a laminotomy involves removing a portion of the lamina just large enough to relieve pressure on the spinal cord and/or nerve root, rather than removing the entire lamina.
Posterior Laminoplasty. This is a technique that helps to retain spinal stability while also expanding the spinal canal. The technique does not fuse or sacrifice range of motion, but utilizes an expansion of the spinal canal volume with preservation of the boney laminae.
Spinal Fusion. For patients who have significant spinal instability, spinal fusion may be performed in addition to decompression surgery to maintain stability in the spine. Spinal hardware such as plates, screws, and rods are used to support the spine and provide additional stability from the posterior (back) side, the anterior (front) side, or both.
In some cases, spinal stenosis procedures can be completed using minimally invasive techniques, which can reduce recovery times.
After surgery, the recovery process can vary based on the type of procedure chosen by you and Dr. Ball. Procedures involving a spinal fusion will typically have longer recovery times, as it can take weeks to months for the bones to completely fuse together. Generally, most patients are able to return to all normal activities within weeks to months of surgery, depending on the procedure.