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Cervical Spinal Stenosis

Cervical spinal stenosis is a narrowing of the spinal canal inside the vertebrae of the neck, known as the cervical vertebrae. As this canal narrows, it can put pressure on the spinal cord and the surrounding nerves, which can lead to neck pain, as well as numbness, tingling and weakness in the shoulders, arms and legs.

All of the orthopedic surgeons at Southwest Scoliosis Institute – Richard Hostin, MD, Shyam Kishan, MD and Kathryn Wiesman, MD – are board-certified, fellowship-trained orthopedic surgeons who have performed surgery on more than 27,000 patients with scoliosis and other complex spine conditions such as cervical spinal stenosis.

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 a combination of both. Other conditions that can lead to cervical spinal stenosis include:

Symptoms

Cervical spinal stenosis can occur with and without symptoms, but when symptoms do occur, they tend to progress over time. The most common symptoms include:

  • Neck pain
  • Numbness or tingling sensation 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

Diagnosis and Testing

The physician at Southwest Scoliosis Institute will go over your medical history with you and perform a thorough physical examination in order to make a diagnosis. During the physical exam, the physician will check to see if you have any difficulty balancing, as well as any reductions in muscle reflexes, loss of sensation, or muscle weakness that may be the result of spinal cord compression.

The doctor will then confirm a diagnosis using a combination of X-ray imaging, computed tomography (CT) scans or magnetic resonance imaging (MRI). While X-rays can show whether there are any issues with the bones of the spine, such as bone spurs, loss of bone height or spondylolisthesis, CT and MRI scans may be needed to reveal if there are any problems with the soft tissue, including the spinal cord and nerves.

Southwest Scoliosis Institute uses a cutting-edge digital low dose X-ray imaging system that takes high-quality images in under a minute. This system can also capture X-ray images of patients while in a standing or seated position, and it’s conveniently located inside our Dallas location, which means that patients can review the X-rays with the physician immediately after they are taken.

Treatment for Cervical Spinal Stenosis

Many patients with cervical spinal stenosis do not require surgery and will see improvements in their condition with the help of nonsurgical treatments. In addition to managing pain and inflammation with non-steroidal anti-inflammatory drugs (NSAIDs), your physician may recommend physical therapy and specific exercises designed to strengthen the muscles in the neck and stabilize the spine. Epidural steroid injections may also be used to decrease swelling in and around any affected nerves.

Spinal Stenosis Surgery

If nonsurgical treatment is not enough to relieve symptoms or if they get worse, your physician at Southwest Scoliosis Institute may recommend surgery. There are several surgical procedures that can be used to treat cervical spinal stenosis, and they are all designed to relieve the pressure on the spinal cord and nerves.

The most common surgical procedures for cervical spinal stenosis are:

  • Anterior Cervical Discectomy and Spinal Fusion. This surgery is typically used when the compression of the spinal cord and nerves is the result of a cervical disc herniation or degenerative disc disease. In it, the surgeon removes all or part of the affected disc and then performs a fusion procedure to stabilize this section of the spine to hold it in place and allow the bones to heal properly.
  • Decompressive laminectomy or laminotomy. This is the most common procedure to correct cervical spinal stenosis. During a laminectomy, the surgeon will remove all or part of the lamina, the back of the vertebra that covers the spinal canal. Sometimes, only a small hole is needed to relieve the pressure on the spinal cord, this is referred to as a laminotomy.
  • Foraminotomy. The foramen is the passage that nerves use to pass from the spinal cord to the rest of the body. In this procedure, the surgeon cuts a small hole in the vertebra to relieve the pressure on the nerves and spinal cord.

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 specialized instruments with magnification to do the surgery. Surgeries performed with minimally invasive procedures are frequently done on an outpatient basis, meaning patients can often return home the same day as their surgery.

“Spinal stenosis is a condition we most typically see in patients over 50 years of age. Some treatments include exercise and physical therapy, lumbar traction, anti-inflammatory medications, and sometimes epidural steroid injections. If patients do not respond to conservative treatment modalitites, surgery can be helpful to open up the space available for the nerves.” – Dr. Richard Hostin

If you or a loved one suffers from spinal pain, you owe it to yourself to call Southwest Scoliosis Institute at 972-985-2797 to make an appointment.