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.

Pressure on the spinal cord causes myelopathy, which a patient may experience as numbness/tingling or a loss of dexterity 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.

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.

Cervical stenosis is a 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").

Anterior options for surgery include anterior cervical discectomy and fusion (ACDF) and cervical disc replacement (arthroplasty). Posterior approaches include cervical laminectomywith or without fusion and laminoplasty. 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.

If you live near Denver and are suffering from cervical stenosis, please consider meeting me in consultation to learn more about your treatment options.