What are the other Names for this Condition? (Also known as/Synonyms)

• Cervical Spinal Canal Stenosis
• Narrow Spinal Canal of Neck
• Spinal Stenosis of Neck

What is Cervical Spinal Stenosis? (Definition/Background Information)

• Spinal stenosis is a degenerative disorder that results in the abnormal narrowing of the spinal canal. This places pressure on the spine and causes pain and associated neurological symptoms
• Cervical Spinal Stenosis affects the spinal cord in the neck region. The condition is caused by a wear and tear of the articular cartilage that covers the bony surface of joints within the cervical region of the spine
• The condition is mostly associated with advancing age and certain inherited disorders such as achondroplasia or scoliosis. Other factors that can cause the condition include injury to the neck, formation of benign or malignant tumor in the region, or thyroid abnormalities
• The signs and symptoms of Cervical Spinal Stenosis may include neck pain that spreads to the shoulder, numbness and tingling sensation in the arms, and functional impairment
• The complications may include paralysis, weakness or fatigue, and complete loss of muscle strength. Surgery to treat the condition may present additional complications such as infection and inadvertent rupture of the spinal cord membrane
• Nonsurgical and surgical methods may be used to treat Cervical Spinal Stenosis. Nonsurgical methods include the administration of medication and physical therapy, while surgery may involve a decompressive laminectomy
• The prognosis of Cervical Spinal Stenosis may vary from one individual to another. It is also dependent upon the underlying cause and severity of the condition. With early diagnosis and treatment, the outcomes may be imporved

Who gets Cervical Spinal Stenosis? (Age and Sex Distribution)

• Individuals of all ages, race, ethnic groups, and gender can develop Cervical Spinal Stenosis
• Although, a high percentage of individuals who develop this degenerative, debilitating, and progressive condition are middle-aged to elderly adults (over 50 years of age)
• If younger individuals develop this condition, it is usually due to a genetic abnormality that affects the entire body, or a neck injury

What are the Risk Factors for Cervical Spinal Stenosis? (Predisposing Factors)

The common risk factors associated with Cervical Spinal Stenosis include:

• Advancing age
• Studies have indicated that spinal stenosis may have a genetic prevalence. Children, who have an immediate family member or relative with a history of the condition, have an increased risk of developing the disorder
• Osteoarthritis: It is a painful joint disorder characterized by the progressive degeneration of the articular cartilage that covers the bone surface of joints. Over time, the cartilage of the joint wears down
• Rheumatoid arthritis: It is a chronic and systemic autoimmune inflammatory disorder that affects the lining of joints, surrounding tissues, and organs, within the body (chiefly the hands and feet) of mostly adults
• Accidents and injuries that involve the spinal cord
• Hypothyroidism: A medical condition characterized by the body’s inability to produce enough thyroid hormone
• Cushing’s syndrome: A disorder caused by high level of secretion of the hormone cortisol by a tumor of the adrenal cortex
• Acromegaly: A hormonal disorder that develops within the pituitary gland, which is caused by the overproduction of growth hormone
• Achondroplasia: A genetic disorder that affects bone growth and development
• Spondylolisthesis: An extremely painful and traumatic injury that involves a vertebra in the spine, which slips forward out of its normal position resulting in abnormal pressure on the nerve roots
• Formation of any tumor in the cervical region of the spine
• Paget’s disease of the bone: It is a chronic disorder that disturbs the normal process of breaking down and remodeling of bones in the body
• Scoliosis: It is a medical disorder characterized by an abnormal curvature of the spine. This disorder is caused by a defect that causes the spine to bend or curve sideways

What are the Causes of Cervical Spinal Stenosis? (Etiology)

Common causes associated with Cervical Spinal Canal Stenosis include:

• Traumatic spinal injuries such as during a vehicular accident; fall injuries
• Children who are born with an abnormally narrow spinal canal (congenital spinal stenosis)
• Abnormal growths on the spine, such as a spinal tumor
• Ruptured or prolapsed cervical disc
• A rare bone disorder called Paget’s disease of bone, which is characterized by abnormal growth and deformity of the bones
• Thickened ligaments within the spinal canal
• Degeneration of the spinal canal, which causes the space between the vertebra to narrow (degenerative osteoarthritis)

What are the Signs and Symptoms of Cervical Spinal Stenosis?

The signs and symptoms associated with Cervical Spinal Stenosis may be mild or severe and can vary from one individual to another. The signs and symptoms include:

• Mild, moderate, or severe pain in the neck region
• Radiating pain down the shoulder and arms (cervical radiculopathy)
• Numbness, weakness, or a tingling sensation in the arm or hand
• Feeling of tiredness
• Functional impairment (hand clumsiness, poor fine motor skills and coordination)

How is Cervical Spinal Stenosis Diagnosed?

Diagnostic tools that aid in identifying Cervical Spinal Stenosis include:

• Complete physical examination with evaluation of medical history
• X-ray of the head and neck region: X-rays are useful in ruling-out other possible causes that have related symptoms
• Magnetic resonance imaging (MRI) scan of the spine: It is the most common diagnostic test used to identify spinal stenosis. An MRI is a more detailed scan that uses radio waves and a magnetic field that generates thorough images of interior bones and soft tissues. An MRI scan can usually identify if the spinal cord is compressed
• CT myelogram: A CT myelogram is a specialized diagnostic imaging procedure that injects a special dye into the surrounding areas of the spinal cord. X-rays or CT scan images are then taken from several different angles. These images are then merged to create cross-sectional images of bones and soft tissues with the body. This allows a healthcare provider to examine the spinal column and surrounding structures and detect any spinal cord abnormalities

Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis.

What are the possible Complications of Cervical Spinal Stenosis?

The complications associated with Cervical Spinal Stenosis may include:

• Partial or total paralysis
• Chronic pain within the neck
• Loss of muscle strength (paraplegia)
• Loss of bladder or bowel control
• A severe compression of the spinal cord in the neck region may lead to a condition known as cervical myelopathy
• Complications that arise from surgery to treat the condition

How is Cervical Spinal Stenosis Treated?

Methods for treating Cervical Spinal Stenosis depend on the severity of the signs and symptoms. The purpose of treatment is to relieve pain and stiffness, help resume regular/daily activities as early as possible, and prevent permanent damage to the spinal cord and surrounding nerves.

• Wearing a specialized neck brace can help rest the muscles while decreasing the range of motion
• Non-steroidal anti-inflammatory oral medications, such as ibuprofen, naproxen, and ketoprofen, may be used to treat the condition. These medications can help decrease pain and swelling
• Individuals, who experience muscle spasms, may be prescribed certain muscle relaxant medications, such as diazepam or cyclobenzaprine, which may help relieve pain within the neck
• Antidepressant medication, such as imipramine, which belong to the family of tricyclic antidepressants, can help relax muscles and reduce muscle spasms
• Anti-seizure drugs, such as gabapentin and pregabalin, are commonly used to decrease pain that is the direct result of damaged nerves
• Corticosteroid injections into the epidural space help in temporary relieving symptoms, such as pain, and in improving the range of motion. It is important to note that corticosteroid injections may only give temporary relief and prolonged episodes of such injection can injure the joints in the long run
• Physical therapy exercises that include strengthening and improving flexibility within the neck can help reduce discomfort. Physical therapy may also include swimming or the use of exercise cycles

Surgical treatment for Cervical Spinal Stenosis:

• Decompressive laminectomy: This is a surgical procedure intended to relieve pressure on the spinal cord and/or nerves by removing the lamina in order to widen the spinal cord. During a laminectomy procedure, the lamina (the small section of the bony roof in the spine) is removed to create additional space for the surrounding nerves within the spinal canal. A bone graft material then fills the empty space and two or more vertebrae of the spine are fused together to create stability. However, this procedure may be also performed without a spinal fusion, or the healthcare provider may elect to perform a discectomy (removing of part the disc)
• Laminoplasty: It is a surgical procedure that is performed to relieve pressure on the spinal cord and/or nerves by moving the lamina to the side, in order to widen the spinal cord. During a laminoplasty procedure, the lamina (the small section of the bony roof in the spine) is moved in order to expand the spinal canal. A bone graft material then fills the empty space and two or more vertebrae of the spine are fused together to create stability. However, this procedure may also be performed without a spinal fusion

In some cases, alternative therapies, such as chiropractic treatment and acupuncture, may be considered. However, it is always recommended to consult a healthcare provider prior to considering any such alternative therapies.

How can Cervical Spinal Stenosis be Prevented?

In some cases, Cervical Spinal Stenosis may be a progressive condition that is difficult to prevent due to risk factors increasing with age. However, certain guidelines that may help slow progression of the condition include:

• Exercise regularly
• Limit activities that may place abnormal stress on the neck or back
• Wear seat belts while driving and sports safety gear
• Begin any new physical activity slowly with a thorough and complete warm-up. Individuals are advised to add low-impact activities to their exercise program
• Individuals, who participate in any high-impact sports, such as football and hockey, should wear appropriate safety equipment to help decrease the risk of developing spinal stenosis
• Maintaining correct posture when standing, sitting or working on the computer, may help relieve unwanted stress on the neck and back
• Maintaining a healthy body weight, which can help reduce unwanted stress on the spine
• Individuals, who maintain a healthy lifestyle, may decrease the likelihood of developing Cervical Spinal Stenosis, or at least slow down progression of the condition

What is the Prognosis of Cervical Spinal Stenosis? (Outcomes/Resolutions)

The long-term prognosis with Cervical Spinal Stenosis depends on the severity of the degenerative disorder an individual develops.

• If the cause of spinal stenosis is detected early and aggressive treatment provided, the quality of life of the individual can be substantially improved. This also helps avoid any serious complications from arising in the neck region
• In some, this disorder may be progressive and debilitating, because of a gradual degeneration of the bones and cartilage within the cervical/neck region 

Additional and Relevant Useful Information for Cervical Spinal Stenosis:

The following article links will help you better understand different surgical treatment methods of spinal stenosis:

http://www.dovemed.com/common-procedures/procedures-surgical/lumbar-laminectomy-and-rhizolysis/