What is cervical stenosis?
Cervical stenosis refers to a narrowing of the spinal canal in the neck, usually due to degenerative arthritis of the spine joints or bulging from a disc in between two vertebrae. Symptoms occur when the narrowing is severe enough to exert pressure on the spinal cord, the nerve roots, or both.
What is cervical myelopathy?
Pressure on the spinal cord in the neck can cause cervical myelopathy, which a patient may experience as numbness/tingling or a loss of dexterity or strength in the hands, neck pain, and trouble with gait or balance. Physical examination signs of myelopathy include muscle weakness or atrophy, loss of sensation, and exaggerated reflex responses.
What is cervical radiculopathy?
Pressure on the nerve roots from cervical stenosis causes cervical radiculopathy, in which a patient may experience pain in the arm that radiates from the neck. There may be muscle weakness, sensory loss, neck pain, or a tingling sensation in the affected parts of the arm, too.
How is cervical stenosis treated?
Cervical stenosis/myelopathy is usually a degenerative condition, meaning that medications and physical therapy have limited roles in reversing it. Surgery is the mainstay of treatment for patients with severe symptoms, and there are surgical options from both the front and the back of the neck (i.e. “anterior” and “posterior”).
What are the surgical options?
Anterior options for surgery include anterior cervical discectomy and fusion (ACDF) and cervical disc replacement (arthroplasty). Posterior approaches include cervical laminectomy with or without posterior fusion and laminoplasty.
If you are considering or planning an ACDF, my ACDF guide for patients explains how to prepare and what to expect before and after surgery.
How do you decide which surgery is right for me?
Each of these options has benefits and drawbacks. The right option for you will depend on your symptoms, the number of spinal levels affected, and factors related to your medical history, age, and spinal anatomy.
Example MRI of Cervical Stenosis
Example MRI (top panels) showing a healthy disc, spinal cord, and nerve roots, and a second MRI (lower panels) showing a disc bulge (yellow arrows) causing compression of the spinal cord and a nerve root. Note that the bright rim of spinal fluid (CSF) cushioning the spinal cord in the top panels disappears due to the disc bulge.
Should I meet with you?
If you live near Denver and have been diagnosed with cervical stenosis, please consider meeting me in consultation to learn more about your treatment options. You can also review my ACDF guide for patients.