Understanding Spinal Stenosis in the Neck Spinal stenosis in the neck, or cervical region of the spine, is a relatively common condition. The term “spinal stenosis” refers to the narrowing of the spinal canal and can be caused by a number of degenerative changes in the spinal column, such as bulging or herniated discs, thickened ligaments, bone spurs, vertebral slippage, and others. When one or more of these abnormalities cause nerve passageways in the cervical spine to narrow, the spinal cord and nerve roots may become impinged, or pinched.To better understand how spinal stenosis can develop in the neck, it can be helpful to briefly review thespinal anatomy.Spinal AnatomyThe spine consists of the following components: Vertebrae – the bones that form the spinal column Facet joints – the hinged connection points of adjacent vertebrae Intervertebral discs – the spongy cartilaginous pads that lie between individual vertebrae Spinal cord and nerve roots – the neural structures that transmit sensory and motor signals between the brain and the rest of the body Spinal canal – the open space through stacked vertebrae, through which the spinal cord travels Foramina – the lateral (side) intervertebral canals through which spinal nerve roots branch off the spinal cord Muscles, ligaments, and tendons – the soft tissues that provide support to the spineWhether due to age-related degeneration, trauma, genetics, or other causes, thespinal components can weaken and/or become damaged, which can cause spinalinstability. For example, arthritis in the facet joints can cause abnormalmovements, weaken nearby muscles and ligaments, and place excessive stress ona disc, which may bulge or herniate as a result. Spinal stenosis in the neck canoccur if the expanded disc material pushes into the spinal canal, and symptomswill likely arise if the spinal cord or a nerve root is compressed.SymptomsNeural compression can lead to a host of symptoms, including pain, numbness, muscle weakness, andtingling. More specifically, cervical nerve root compression can cause these symptoms to radiate intothe shoulder, arm, hand, and fingers, and chronic headaches may also occur. Compression of the spinalcord can lead to these symptoms and others, including arm weakness or stiffness, unsteady gait, andsensory loss. In severe cases of spinal cord compression, paralysis from the neck down may occur.
Treatments Typically, a doctor will first recommend a course of conservative (nonsurgical) treatments to a patient with spinal stenosis in the neck. Conservative methods usually include non-steroidal anti-inflammatory drugs (NSAIDs), narcotic pain medications, physical therapy, hot/cold therapy, low-impact exercise, and neck braces, among others. Although the mainstream medical community debates the efficacy of alternative, holistic treatments, some patients may choose to explore these methods (massage, yoga, acupuncture, acupressure, etc.) in lieu of or to complement conservative treatments.SurgeryCervical spinal stenosis surgery is seldom required, as most patients are able to find relief from severalweeks or months of conservative or alternative treatments. In the event that nonsurgical methods fail toalleviate symptoms, a doctor may suggest a surgical decompression procedure. Before signing anyconsent forms, patients should completely understand all of the risks and benefits associated with thevariety of procedures that may be available to them.