Any problem in your neck is potentially serious because it connects your head to your body, and the structures within it are necessary for life. Cervical stenosis occurs when the spinal cord or spinal nerves are compressed due to narrowing in the seven vertebrae in your neck.
When we use the term, “cervical stenosis,” we are usually talking about degenerative changes that cause narrowing, such as arthritis. Cervical spinal injuries can cause cervical stenosis, too, and may be much more serious. A herniated disc or cervical fracture that damages the spinal cord or a spinal nerve root can be life-threatening.
Symptoms The symptoms associated with cervical stenosis depend on whether the spinal cord or spinal nerve is being compressed. If it’s spinal nerves, symptoms will be limited to the neck, shoulders and arms. Symptoms include neck, shoulder or arm pain, numbness, heaviness or tingling, arm weakness or difficulty grasping objects.
If the spinal cord is compressed, you can also have muscle spasms and pain in your legs, loss of coordination and be unsteady when you walk.
Treatment Early cervical stenosis can be treated with anti-inflammatory medications and pain medications. If the pain is severe or if there are functional problems (arm weakness, difficulty walking, etc), surgery is usually necessary. Both minimally invasive and open surgical techniques are used to treat cervical stenosis, and either an anterior (through the front) or posterior (through the back) approach may be needed.
Discectomy—the disc between vertebrae is removed, along with any bone spurs, to relieve nerve pressure. The disc may be replaced with a bone graft or an artificial disc. Cervical discectomy usually requires an anterior approach.
Corpectomy—the body of the vertebra and the intervetebral discs are removed, enlarging the spinal canal. The vertebrae are usually fused together with a bone graft or hardware; an anterior approach is used.
Laminectomy, laminotomy, laminoplasty—the lamina is the bone at the back of the vertebra. It’s removed in a laminectomy, partially removed to make a larger opening for the nerve in a laminotomy or repaired in a laminoplasty. Laminal surgery is done from the back. Laminotomy and laminoplasty can sometimes be done with an endoscope.
Facetectomy—removal of the facet joint between two vertebrae to enlarge the opening.
Surgery usually improves the symptoms of cervical stenosis, but doesn’t always resolve them. By the time cervical stenosis is severe enough to warrant treatment, there may be some permanent nerve damage. In addition, symptoms can reappear as aging and degeneration continue.