Cervical spinal stenosis is narrowing of the canal through which the spinal cord passes in the neck. When it compresses the cord, it can cause reduced hand dexterity, gait disturbance and numbness in the arms.
What is cervical spinal stenosis?
Cervical spinal stenosis is narrowing of the spinal canal in the neck caused by age-related disc wear, bone spurs (osteophytes), and thickening or ossification of ligaments. When the canal becomes narrow enough, the spinal cord is compressed — a condition called cervical myelopathy.
Cervical myelopathy usually begins insidiously and progresses slowly. Early diagnosis matters so that treatment can be planned before permanent damage to the spinal cord occurs.
Symptoms
- Numbness and clumsiness of the hands (difficulty buttoning, writing or holding small objects)
- Gait disturbance, imbalance and frequent tripping
- Weakness in the arms and legs
- Neck pain and pain radiating into the arms
- Impaired bladder control in advanced cases
Diagnosis
Neurological examination looks for signs typical of cord compression, such as brisk reflexes. Cervical MRI shows the degree of narrowing and whether there is signal change in the spinal cord. CT helps assess bone spurs and ligament ossification.
Treatment Approach
Mild stenosis without signs of spinal cord compression can be managed with observation, physiotherapy and pain treatment. When cervical myelopathy develops, surgical decompression is generally recommended to halt progression and protect the spinal cord. Depending on the location and extent of narrowing, one of the following is chosen:
- Anterior approach: Discectomy or corpectomy with fusion
- Posterior approach: Laminoplasty or laminectomy, with fusion if needed
The main goal of surgery is to prevent further deterioration; the extent to which deficits present before surgery improve varies from person to person.