Cervical Spinal Stenosis

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Topic Overview

What is cervical spinal stenosis?

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 the spinal cord itself. The 7 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. Other problems can include a loss of bowel and bladder control (incontinence). Cervical spinal stenosis can be crippling if the spinal cord is damaged.

What causes cervical spinal stenosis?

Cervical spinal stenosis is usually caused by age-related changes in the shape of the spinal canal and so is most common in people over 50 years of age. The aging process can cause a "bulging of the discs," which is 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 experience 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.
• Incontinence.

How is cervical spinal stenosis diagnosed?

A diagnosis of cervical spinal stenosis usually is based on your history of symptoms and a physical examination. Your health professional will ask you if neck movements cause pain, numbness, or weakness. If cervical spinal stenosis is suspected, your health professional 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), amyotrophic lateral sclerosis (ALS), and vitamin B12 deficiency—as the cause of your symptoms.

How is it treated?

In mild to moderate cases of spinal stenosis, symptoms can usually be controlled with medication 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 health professional may recommend 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 incontinence and permanent loss of strength and feeling in the arms, hands, and legs. Your health professional may not wait for you to experience severe symptoms of pain, weakness, and numbness before considering treatment to relieve pressure on your spinal cord and nerves.

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Last updated:	March 14, 2006
Author:	Amy Fackler, MA
Reviewed By:	William M. Green, MD - Emergency Medicine, Robert B. Keller, MD - Orthopedics
Editors:	Sydney Youngerman-Cole, RN, BSN, RNC, Pat Truman