Cervical stenosis is the narrowing of the vertebral canal in the neck. It is a common cause of neck pain and is more common in elderly patients. Up to 26% percent of people over the age of 64 may have cervical stenosis despite not having any symptoms.
Causes of cervical stenosis
The spinal cord is an important part of the central nervous system that carries signals between the brain and the body. It is protected by the vertebral column, a series of bones that surround and support it. In the cervical region, the spinal cord contains nerves that control movement and sensation in the arms, legs and bowel and bladder function. If the vertebral column in this region narrows, it can put pressure on the spinal cord and cause neurological problems.
The vertebral canal in the neck can narrow over time due to age-related changes, leading to compression of the spinal cord and nerves. Other causes include spine trauma, rheumatoid arthritis and bone diseases. Some people may be born with a narrow vertebral canal in the neck. Flexing the neck may worsen symptoms.
Symptoms of cervical stenosis
Symptoms may vary depending on the severity of stenosis and spinal cord compression. Common symptoms include:
- Neck pain
- Weakness in arms and legs
- Loss of sensation in arms and legs
- Shooting pain down the arms
- Difficulty walking
- Loss of bowel/bladder control
Diagnosis of cervical stenosis
Often the history of symptoms and physical exam may lead to suspicion of cervical stenosis, however, an MRI of the cervical spine is usually necessary for confirmation.
Treatments for cervical stenosis
Depending on the severity of symptoms, patients may be offered surgical or nonsurgical options. Nonsurgical options can help manage symptoms, but they usually do not cure the underlying problem. Surgical treatment is the only cure for cervical stenosis and can improve symptoms in up to 90% of patients.
Nonsurgical options include neck immobilization, non-steroidal anti-inflammatory drugs (NSAIDS), e.g., ibuprofen, naproxen, aspirin, physical therapy and steroid injections.
Surgical options aim to relieve pressure on the spinal cord and provide stability to the neck. Common procedures are posterior cervical laminectomy, discectomy and fusion, or corpectomy.
