Cervical Stenosis: An Overview
Cervical stenosis occurs when the spinal canal becomes too narrow in the cervical or neck region. Due to this narrowing, the spinal cord and nerve roots don’t have enough space and become compressed, putting pressure on the spinal cord and nerves that exit at the cervical spine level which affects other areas of the body. In sever cases, this can eventually lead to either myelopathy or radiculopathy, or both.
What are the main causes of cervical stenosis?
In most cases, cervical stenosis is caused by the “wear and tear” on the spine that is caused by aging. That is why this condition is very common to people over the age of 50. People can also be born with the condition due to their genetic makeup. Others have developed cervical spinal stenosis because of an accident or a major trauma affecting the neck.
Less common causes of cervical stenosis causes also include:
- Spinal tumors or abnormal growths forming in your neck,
- Paget’s disease of the bone, and
- Flurosis or excess of fluoride in the body.
Cervical Stenosis Symptoms
The signs and symptoms of cervical spinal stenosis develop gradually after a certain period of time, and may include the following:
- Pain, stiffness or numbness in the neck, back, shoulders, arms, or legs.
- Problems with balance and coordination, which may lead to shuffling or tripping while walking.
- Loss of bowel or bladder control. As stenosis in the neck area can put pressure on the spinal cord, the nerves to the bladder may also be affected that can lead to incontinence.
How to diagnose cervical spinal stenosis?
A diagnosis is based usually on your symptoms, health history, and a physical examination. Actually diagnosing spinal stenosis can be difficult as its symptoms also resemble those other age-related conditions. If a real problem of stenosis in your neck is suspected, the doctor will typically recommend medical imaging tests to confirm the diagnosis. Imaging tests may involve X-rays, MRI, and CT scans. In today’s day and age, an MRI is usually the most detailed image that can be taken of the internal body and is usually the most accurate method in making a correct diagnosis.
Available Cervical Stenosis Treatments and Drugs
Mostly, cervical stenosis can be successfully treated using non-invasive or non-surgical techniques such as anti-inflammatory medications, physical exercises, and rest. If over-the-counter (OTC) pain relievers are not enough to relieve the pain, a doctor may prescribe:
- Anti-seizure drugs such as pregabalin (Lyrica) and gabapentin (Neurontin).
- Antidepressants
- Opioids such as hydrocodone (Vicodin) and oxycodone (Percocet).
When non-operative care does not improve your condition, or you’re already disabled by the symptoms, your doctor may recommend surgery. The goal is to relieve your spinal cord or nerves from the pressure. Some of the popular surgical treatments are:
- Laminectomy. The surgeon will remove the lamina or the back part of the affected vertebrae to give enough space within nerve passageways or the spinal canal.
- Foraminotomy. This surgical process will remove the lower exit of the vertebrae to create more room for nerves.
- Cervical corpectomy. Some portions or discs of the vertebrae are removed to allow room for nerves.
Cervical stenosis surgery helps reduce the symptoms. However, like all surgery, there are surgical risks due to the patient undergoing a general anaesthetic or like an infection in the spinal cord. In some cases after surgery, sometimes the symptoms remain the same, or even get worse.
How to Prevent Cervical Stenosis
As the major cause of cervical stenosis is aging and wear and tear of the spine, the best preventative measure is to maintain an ideal weight, exercise regularly and employ correct form and position of the spine where ever possible (like when sitting at a desk in an office environment).