Cervical Stenosis

About Cervical Stenosis

Cervical stenosis refers to any condition that produces narrowing of the spinal canal. When the spinal canal becomes more narrow the spinal cord and nerve roots may become compressed. This compression changes how the spinal cord or nerves functions and can cause pain, numbness, or weakness in the neck, arms, and/or legs. Severe cases can produce symptoms related to spinal cord compression, known as a cervical myelopathy.

Age-related changes in the spinal canal are the most common causes of cervical stenosis. Most cases occur in people older than 50. In rare cases the spinal canal is narrow from birth, predisposing patients to symptoms from relatively mild degenerative changes, a condition known as congenital stenosis.

Common Symptoms of Cervical Stenosis

Many people over 50 will experience narrowing of the spinal canal and will show no symptoms. Symptoms will not appear unless the spinal cord or nerves become compressed. It usually takes a long period of time for these symptoms to develop. Some common symptoms include:

  • Stiffness (neck, shoulders, arms, hands, or legs)
  • Pain (neck, shoulders, arms, hands, or legs)
  • Numbness (neck, shoulders, arms, hands, or legs)
  • Weakness (neck, shoulders, arms, hands, or legs)
  • Balance and coordination problems
  • Loss of bowel or bladder control

Diagnosis of Cervical Stenosis

A careful history and physical exam are the usual starting points to identify the potential for cervical stenosis. Imaging tests confirm the diagnosis and include X-rays, MRI, and CT scans. These studies are used to define the extent and degree of stenosis.

Treatment Options for Cervical Stenosis

In mild cases of cervical stenosis treatment options may include:

  • Medication
  • Exercise
  • Physical therapy.

When pain does not respond to conservative care or neurological deficits develop due to spinal cord or nerve compression, decompressive surgery will likely be recommended. This procedure may be done from the front or back of the neck, and may involve removing the disc, ligaments, and bone that are pressing on the nerve roots. A spinal fusion is usually performed as well to restore stability to the cervical spine.