Osteoarthritis Osteoarthritis (OA) Osteoarthritis is a chronic disorder that causes damage to the cartilage and surrounding tissues and is characterized by pain, stiffness, and loss of function. Arthritis due to damage of joint... read more , disc bulges and herniations, and spondylolisthesis Spondylolisthesis Spondylolisthesis is partial displacement of a bone in the lower back. Injuries or a degenerative condition can cause this disorder. Pain is felt in the low back and may travel down one or both... read more can cause narrowing of the spinal canal.
Symptoms, if present, can include neck pain Neck Pain Along with low back pain, neck pain is a very common reason for health care visits. The pain usually results from problems with the musculoskeletal system—the spine, including the bones of the... read more ; tingling in the arm, hand, leg, or foot; and weakness and loss of balance.
The diagnosis is based on a doctor's evaluation and sometimes on the results of imaging or electrodiagnostic tests.
Treatment includes measures to relieve pain and sometimes surgery.
The spinal canal runs through the center of the spine and contains the spinal cord Spinal Cord The spinal cord is a long, fragile tubelike structure that begins at the end of the brain stem and continues down almost to the bottom of the spine. The spinal cord consists of bundles of nerve... read more and the bundle of nerves that extends downward from the bottom of the spinal cord in the lower back.
Along the length of the spinal cord are the spinal nerves. The spinal nerves emerge from the sides through spaces between the vertebrae to connect with nerves throughout the body. The part of the spinal nerve nearest the spinal cord is called the spinal nerve root. Because of their location, spinal nerve roots can be squeezed when the spinal canal is narrowed, resulting in pain.
The most common causes of cervical spinal stenosis include osteoarthritis Osteoarthritis (OA) Osteoarthritis is a chronic disorder that causes damage to the cartilage and surrounding tissues and is characterized by pain, stiffness, and loss of function. Arthritis due to damage of joint... read more , disc degeneration, and spondylolisthesis Spondylolisthesis Spondylolisthesis is partial displacement of a bone in the lower back. Injuries or a degenerative condition can cause this disorder. Pain is felt in the low back and may travel down one or both... read more . Other causes include ossification of the posterior longitudinal ligament, ankylosing spondylitis Ankylosing Spondylitis Ankylosing spondylitis is a spondyloarthritis characterized by inflammation of the spine (spondylitis), large joints, and fingers and toes, resulting in stiffness and pain. Prolonged joint pain... read more , and Paget disease of bone Paget Disease of Bone Paget disease of bone is a chronic disorder of the skeleton in which areas of bone undergo abnormal turnover, resulting in areas of enlarged and softened bone. The breakdown and formation of... read more .
A column of bones called vertebrae make up the spine (spinal column). The vertebrae protect the spinal cord (a long, fragile structure contained in the spinal canal), which runs through the center of the spine. Between the vertebrae are disks composed of cartilage, which help cushion the spine and give it some flexibility.
Spinal nerves: Emerging from the spinal cord between the vertebrae are 31 pairs of spinal nerves. Each nerve emerges in two short branches (roots)—motor and sensory—which join to form a spinal nerve.
The motor roots carry commands from the brain and spinal cord to other parts of the body, particularly to skeletal muscles.
The sensory roots carry information to the brain from other parts of the body.
Cauda equina: The spinal cord ends about three fourths of the way down the spine, but a bundle of nerves extends beyond the cord. This bundle is called the cauda equina because it resembles a horse's tail. The cauda equina carries nerve impulses to and from the legs, lower intestine, and bladder.
Symptoms of Cervical Spinal Stenosis
Some people with cervical spinal stenosis do not have symptoms.
Other people have neck pain Neck Pain Along with low back pain, neck pain is a very common reason for health care visits. The pain usually results from problems with the musculoskeletal system—the spine, including the bones of the... read more and limited range of neck motion. Symptoms of spinal cord compression Compression Fractures of the Spine In a compression fracture of the spine, the drum-shaped part (body) of one or more back bones (vertebrae) collapses into itself and becomes squashed (compressed) into a wedge shape. Most compression... read more include numbness or tingling in the arm, hand, leg or foot, weakness, or a loss of balance.
Diagnosis of Cervical Spinal Stenosis
A doctor's evaluation
Sometimes imaging tests, electrodiagnostic studies, or both
Doctors typically make the diagnosis of cervical spinal stenosis based on the person's symptoms and physical examination. During a physical examination, doctors check a person's strength and reflexes.
Doctors may do other tests if people have weakness or numbness or if their symptoms have lasted for more than 6 weeks. Magnetic resonance imaging Magnetic Resonance Imaging (MRI) In magnetic resonance imaging (MRI), a strong magnetic field and very high frequency radio waves are used to produce highly detailed images. MRI does not use x-rays and is usually very safe... read more (MRI) and computed tomography Computed Tomography (CT) In computed tomography (CT), which used to be called computed axial tomography (CAT), an x-ray source and x-ray detector rotate around a person. In modern scanners, the x-ray detector usually... read more (CT) are imaging tests that can help doctors identify abnormalities of the spine that are causing cervical spinal stenosis. Tests of the nerves and muscles Nerve and muscle tests A doctor can often diagnose a musculoskeletal disorder based on the history and the results of a physical examination. Laboratory tests, imaging tests, or other diagnostic procedures are sometimes... read more (electrodiagnostic tests), such as nerve conduction studies and electromyography, can help doctors identify the affected area of stenosis and the severity of the damage.
Treatment of Cervical Spinal Stenosis
Measures to relieve pain
Sometimes surgery for severe pain
Measures to relieve pain
Applying cold Cold therapy (cryotherapy) Professional rehabilitation therapists treat pain and inflammation. Such treatment makes movement easier and enables people to participate more fully in rehabilitation. Techniques used include... read more (such as ice packs) or heat Heat therapy Professional rehabilitation therapists treat pain and inflammation. Such treatment makes movement easier and enables people to participate more fully in rehabilitation. Techniques used include... read more (such as a heating pad) or using over-the-counter analgesics (such as acetaminophen and nonsteroidal anti-inflammatory drugs [NSAIDs]) may help relieve the pain. Some people may be helped by corticosteroids taken by mouth.
People should sleep on their back with a thin pillow under the neck to keep the cervical spine aligned.
Physical therapy Physical Therapy (PT) Physical therapy, a component of rehabilitation, involves exercising and manipulating the body with an emphasis on the back, upper arms, and legs. It can improve joint and muscle function, helping... read more may help relieve symptoms. Physical therapy focuses on posture, motion, and strength of the muscles around the neck to relieve symptoms.
When measures to relieve pain are not effective in people with cervical stenosis, surgery may be needed to relieve pressure on the spinal cord and spinal nerves.
One surgical procedure is called a cervical laminectomy, in which a portion of the vertebrae called the lamina is removed, taking pressure off the spinal cord and spinal nerves. Laminectomy of the cervical spine is almost always includes attachment of adjacent vertebrae (fusion) to avoid a common consequence of abnormal curvature of the spine in the neck (cervical kyphosis). The more common approach is a cervical decompression from the front (anterior) combined with a removal of the disc and fusion.
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