Cervical spinal stenosis is the narrowing of the spinal canal in the
neck. The spinal canal is the open area in the bones (vertebrae) that
make up the
spinal column. The
spinal cord is a collection of nerves that runs
through the spinal canal from the base of the brain to the lower back. These
nerves allow us to feel, to move, and to control the bowel and bladder and
other body functions. In cervical spinal stenosis, the spinal canal narrows and
can squeeze and compress the nerve roots where they leave the
spinal cord, or it may irritate or injure the spinal cord itself. The seven
vertebrae between the head and the chest make up the cervical spine. Squeezing
the nerves and cord in the cervical
spine can change how the spinal cord functions and
cause stiffness, pain, and numbness in the neck, arms, and legs.
Because there are many causes of back pain, it is important for your doctor to do a thorough history and physical examination to determine if a spinal disk problem is the root of your back pain. A herniated or slipped disk may press on the nerves coming out from the spinal cord, and it may show up in a targeted neurological exam. Your doctor will check your reflexes, muscle strength, and sensation for abnormalities or changes, especially those that involve the lower extremities.
A spinal X-ray may...
Cervical spinal stenosis is usually caused by age-related changes in
the shape of the spinal canal and so is most common in people older than age
50. The aging process can cause a "bulging of the discs"-the spongy discs
between the bones of the spine bulge out farther than normal-or a thickening of
tissues that connect bones (ligaments). Aging can also lead to
destruction of tissues that cover bones (cartilage) and
excessive growth of the bones in joints. These conditions can narrow the spinal
canal (spinal stenosis).
What are the symptoms?
Many people older than age 50 have some narrowing of the spinal canal
but do not have symptoms. Cervical spinal stenosis does not cause
symptoms unless the spinal cord or nerves becomes squeezed. Symptoms usually
develop gradually over a long period of time and may include:
Stiffness, pain, or numbness in the neck,
shoulders, arms, hands, or legs.
Balance and coordination problems,
such as shuffling or tripping while walking. Cervical
spinal stenosis can be crippling if the spinal cord is
A diagnosis of cervical spinal stenosis usually is based on your
history of symptoms and a physical exam. Your doctor will
ask you if neck movements cause pain, numbness, or weakness. If cervical spinal
stenosis is suspected, your doctor will probably recommend imaging
tests of your neck and back to confirm the diagnosis and to see what is causing
the narrowing of the spinal canal. Imaging tests that may be used include
X-rays, magnetic resonance imaging (MRI), and computed tomography (CT) scans. Your health professional will use the
results of tests, including imaging and blood tests, to eliminate other
diseases-such as multiple sclerosis (MS) and
vitamin B12 deficiency-as the cause of your
How is it treated?
In mild to moderate cases of spinal stenosis, symptoms can usually be
controlled with medicine to relieve pain, exercise to maintain strength and
flexibility, and physical therapy. If your symptoms are severe, you have
progressive weakness of your muscles, or the pictures of your spine show that
your spinal cord or nerves are being tightly squeezed, your doctor may
decompressive surgery to relieve the pressure. This
surgery may be done from the front or the back of the neck. It involves
removing some of the disc, bone, and/or tissue that may be pressing on the
nerve roots. Vertebrae are often joined together surgically (fused) to provide stability to the spine.
Cervical spinal stenosis can potentially cause serious problems with
the nervous system, including problems with bowel or bladder control
(incontinence) and permanent loss of strength and feeling in the arms, hands,
and legs. Your doctor will not wait for you to have severe symptoms of
pain, weakness, and numbness before considering treatment to relieve pressure
on your spinal cord and nerves.
Primary Medical Reviewer
William M. Green, MD - Emergency Medicine
Specialist Medical Reviewer
Robert B. Keller, MD - Orthopedics
February 17, 2010
WebMD Medical Reference from Healthwise
February 17, 2010
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