Cervical Spinal Stenosis Treatment Options
Cervical spinal stenosis is a condition characterized by the narrowing of the spinal canal in the neck region. This narrowing can compress the spinal cord and/or nerve roots that pass through the canal. It’s a common and progressive condition that causes neck pain. Stenosis can result from various causes, including degenerative changes such as osteoarthritis, disc herniation, thickening of ligaments, spinal injuries, or tumors.
Cervical spinal stenosis is often caused by age-related changes in the spine, such as osteoarthritis, rheumatoid arthritis, disc herniation, disc degeneration, and ligament thickening and calcification. Other conditions that cause cervical spinal stenosis include tumors of the spine, fractures of the vertebrae, and inherited conditions such as scoliosis.
In some cases, spinal stenosis can affect two areas of the spine: cervical and lumbar stenosis. This is called tandem spinal stenosis. Many times, there are no symptoms and other times, it can cause severe symptoms in the legs. Sometimes, the condition is identified by X-rays. This condition affects about 60% of patients. Tandem stenosis will impact Dr. Ball’s decision-making.
Symptoms of cervical spinal stenosis may vary depending on the severity and location of the canal narrowing. Common symptoms include:
- Neck pain and stiffness
- Numbness or tingling that radiates into the arms, hands, legs, or feet.
- The loss of fine motor skills causes muscle weakness in the hands, arms, or fingers, affecting grip strength and coordination.
- Problems with balance
- In severe cases, stenosis can lead to bowel and bladder dysfunction and sexual dysfunction.
Treatment of cervical spinal stenosis may be conservative (nonsurgical) or surgical, depending on the severity of symptoms and the degree of compression.
Nonsurgical treatment includes:
- Physical therapy to maintain motion in the spine and strengthen the core and back muscles to help stabilize the spine.
- Bracing provides support and assists in regaining mobility.
- Acupuncture may help with the pain.
- Chiropractic manipulation of the spine may help improve mobility and reduce pain.
- Over-the-counter medications to treat pain and inflammation. Prescription pain relievers for severe or acute pain.
- Corticosteroid injections for radiating pain.
- Activity modification is important. Including swimming and nonimpact exercise is beneficial.
- Home exercises can alleviate symptoms.
When conservative measures fail or if neurological deficits are severe or worsening, surgery may be recommended. Common surgical procedures include:
- Laminectomy: A laminectomy involves removing part of the vertebra, and bone spurs help open the spinal column and relieve pressure on the spinal cord or nerves. Dr. Ball may also perform a discectomy during this procedure to treat a herniated disc causing pressure on the cord or a nerve root. He may also perform a facetectomy, which involves removing part or all of a facet joint to relieve pressure.
- Foraminotomy: Enlargement of the nerve root exit spaces (foramina) to relieve nerve root compression.
- Posterior Cervical Laminoplasty: Reshaping the spinal canal to give more room for the spinal cord without removing the vertebral arch.
- Spinal Fusion: This surgery treats age-related degenerative spine changes by joining together two or more vertebrae that have moved out of position. During this procedure, Dr. Ball will remove the disc between the vertebrae and use bone grafts and metal implants to secure the bones.
Each case of cervical spinal stenosis is unique. Dr. Ball will create a treatment plan tailored to the individual patient’s needs, health status, and severity of the condition. Treatment goals are to relieve pain, restore function, and prevent further neurological damage.
Contact Dr. Hieu Ball to schedule a consultation at his San Ramon. He offers a full range of treatments for neck pain. Dr. Ball offers state-of-the-art patient-centered care for patients with neck, mid-back, and low-back problems. He received his orthopedic and spine surgery residency and fellowship training at Harvard Medical School and UCLA-affiliated institutions. Education included training at Massachusetts General Hospital, Brigham and Women’s Hospital, and Boston Children’s Hospital. Dr. Ball is a double fellowship-trained orthopedic spine surgeon. He received a pediatric spine fellowship at Boston Children’s Hospital and a second adult spine fellowship at UCLA. Dr. Ball offers minimally invasive spine care, and many procedures often may be performed on an outpatient basis in an ambulatory surgical center setting.
References
- https://www.niams.nih.gov/health-topics/spinal-stenosis/diagnosis-treatment-and-steps-to-take
- Baker JF. Evaluation and Treatment of Tandem Spinal Stenosis. J Am Acad Orthop Surg. 2020 Mar 15;28(6):229-239. doi: 10.5435/JAAOS-D-18-00726. PMID: 31663913.
At a Glance
Dr. Hieu Ball
- Double fellowship-trained orthopedic
- Orthopedic surgery residency at Harvard Medical School
- Over 20 years of spine surgery experience
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