CERVICAL SPINAL STENOSIS

At Southwest Scoliosis Institute, our board-certified, fellowship-trained orthopedic doctors, have treated thousands of patients with complex spine conditions, including cervical spinal stenosis.

SWSI Scoliosis Quiz

CERVICAL SPINAL STENOSIS

When you come to our offices, you will find that all of the orthopedic surgeons at Southwest Scoliosis Institute – Richard Hostin, MD, Shyam Kishan, MD, and Kathryn Wiesman, MD – are board-certified, and fellowship-trained who have performed surgery on more than 30,000 patients with scoliosis and other complex spine conditions such as cervical spinal stenosis.

To begin with, Cervical spinal stenosis usually occurs in older adults as the result of normal age-related causes like wear and tear, as well as conditions such as arthritis, or due to both.  Also, other conditions that can lead to this include:

  • Cervical disc herniation
  • A condition in which one vertebra slips over the one beneath it
  • Bone spurs
  • Injuries to the vertebrae and/or disc(s)
  • Spinal tumors
  • Prior spine surgery

Cervical Spinal Stenosis Symptoms

Cervical spinal stenosis does not always come with symptoms, especially in cases where the nerves in that area manage to escape compression or the spinal cord is spared from the effects.

However, the symptoms that may come with spinal stenosis differ both in type and in severity. Since the narrowing of the canal and compression of the nerve roots is usually a gradual process, the symptoms may not be present or be extreme when this condition first develops.

As it progresses, the pain, weakness, and tingling sensations that come along with it also get more pronounced, the neck pain travels towards other body parts like the shoulders, arms, and even the legs.

Effects of Cervical Stenosis

One of the effects of cervical stenosis is Cervical Radiculopathy, where pinching or compression of nerves in the neck by the cervical spine causes burning pain, weakness, tingling sensations, or numbness radiating into the upper body and arms depending on the affected nerves. Specific head or neck movements may worsen the symptoms and the longer they last, they may cause paralysis or become permanent.

More extreme cases of spinal stenosis involve compression of the spinal cord and Cervical Myelopathy which can be a result of wear and tear that aging brings. Cervical myelopathy can lead to two types of symptoms including the ones felt in the neck as pain and more permanent nerve damage occurring below the region of compressed nerves, which can cause difficulty in walking or maintaining balance.

Upon reviewing this condition, doctors notice that it can occur with and without symptoms, but when symptoms do occur, they tend to progress over time. Furthermore, the most common symptoms include:

  • Neck pain
  • Numbness or tingling in the hands, legs or feet
  • Muscle weakness in the hands, legs or feet
  • Difficulty/imbalance while walking or standing
  • Difficulty with fine hand movements
  • In severe cases, loss of bladder or bowel control

Pain Associated With Cervical Stenosis

Pain is one of the most prominent hallmarks of nerve damage with this condition. The wear and tear of the cervical spine alongside the narrowing of the spinal canal gives rise to symptoms of cervical stenosis including pain. The pain could arise from various sources or be referred to different body parts due to nerve involvement.

Some of the painful symptoms of cervical stenosis include:

Neck Pain

Neck pain is a common side effect of cervical stenosis with numbness and tingling extending to points below the nerve compression including the arm, hand, legs, and feet.

This may come along with weakness causing clumsiness and balance problems in most people.

Loss of Function

A cause of emotional pain may be the apparent loss of function that affected individuals may experience including the inability to properly use the hands for functions like writing, buttoning, or more.

Loss of Bowel Control

In extreme cases, affected individuals may experience a loss of bladder control and incontinence or even bowel control. This may be due to specific nerve damage associated with spinal stenosis and its effects on the spinal cord.

 

Findings and Testing

In order to make a finding, our doctors will go over your medical history with you and perform a thorough physical exam. During the physical exam, the doctor will check to see if you have any balance problems, as well as any loss of muscle reflexes, loss of sensation, or muscle weakness that may be the result of spinal cord compression.  In addition, the doctor will then test using X-rays, CT scans, or MRI imaging.  To be specific, CT and MRI scans reveal problems with the soft tissue, including the spinal cord and nerves.

Meanwhile, our practice utilizes a digital low dose X-ray system that takes high-quality images in under a minute. Also, this system can capture X-ray images of patients while in a standing or seated position.  Moreover, the equipment is located inside our Dallas office where patients and doctors can review the X-rays quickly.

Neck X-ray skeleton

X-ray of Neck (cervical spine)

Stenosis Spinal vertebrae

Illustration of normal canal and narrowing of canal

Treatment for Cervical Spinal Stenosis

With this condition, many patients do not require surgery and will get better with the help of certain medicines. In addition to NSAID drugs, your doctor may recommend physical therapy.  Also, physical therapy will strengthen the muscles in the neck and stabilize the spine. Sometimes, epidural steroid injections may also be used to decrease swelling in and around any affected nerves.

Spinal Stenosis Surgery

If nonsurgical treatments do not relieve symptoms or if they get worse, your doctor may recommend surgery.  In order to treat cervical spinal stenosis, there are several surgical procedures that relieve spinal cord pressure.  The most common surgical procedures for this condition consist of the following by one of our expert doctors:

Anterior Cervical Discectomy and Spinal Fusion

When cervical disc herniation or degenerative disc disease is found, this surgery is typically used.  In order to correct the problem, the surgeon removes all or part of the affected disc.  Then the surgeon performs a fusion to stabilize the spine to allow the bones to heal properly.

Decompressive laminectomy

In short, this is the most common procedure to correct cervical spinal stenosis.  During a laminectomy, the surgeon will remove all or part of the lamina from the back of the vertebra.  Sometimes, only a small hole needs to relieve the pressure on the spinal cord.

Foraminotomy

For nerves to pass from the spinal cord to the rest of the body, they use the foramen as their passageway.   In this procedure, the surgeon cuts a small hole in the vertebra to relieve the pressure on the nerves and spin.

In addition, these surgeries may even be performed using minimally invasive techniques.  To do this, the surgeon makes a tiny (3 to 15 millimeter) incision and uses special instruments to conduct the surgery.  With minimally invasive procedures, doctors normally allow patients to return to their homes the same day after surgery.

“To be specific, spinal stenosis is a condition we most typically see in patients over 50 years of age. When we treat this condition, we recommend exercise and physical therapy, lumbar traction, medicines, and sometimes epidural steroid injections. If patients do not respond to these conservative treatments, surgery can open up the space available for the nerves.”

Richard Hostin, MD

If you or a loved one suffers from spinal pain, you owe it to yourself to call Southwest Scoliosis Institute at
214-556-0555 to make an appointment.