What Is Cervical Canal Stenosis?
Cervical canal stenosis is when the spinal canal in the neck becomes narrowed. This narrowing puts pressure on the spinal cord and nerve roots, resulting in pain and numbness in the arms, hands and legs. It is related to the natural aging process and most commonly occurs in people age 50 and over.
The cervical spine starts at the base of the skull and involves the first seven vertebrae in the spine. The spinal cord runs from the base of the skull to the lower back through an opening in each vertebra; this passageway is called the spinal canal.
The vertebrae are separated by discs. Facet joints connect the vertebrae to each other and ligaments hold each vertebra together. Through the normal aging process, the discs, vertebrae and facet joints begin to break down. Bulging discs, thickening of the ligaments and bone spurs around the discs and facet joints can cause narrowing of the spinal canal. This narrowing, or stenosis, squeezes the nerve roots and can irritate or damage the spinal cord.
Symptoms of cervical canal stenosis begin to appear around age 50 or later. Numbness and tingling in the arms, hand and legs are the most common symptoms. Other symptoms include:
- Neck or shoulder pain or stiffness
- Weakness, loss of control or loss of strength in the legs
- Loss of balance and coordination
A history and physical examination by a physician is the first step in diagnosing cervical canal stenosis. The physician will ask about previous neck problems, duration and severity of pain and whether other symptoms are present. The physician will check neck rotation, test reflexes and arm and leg strength, and look for signs of nerve inflammation. The physician may order additional tests, including:
- X-rays to see whether there is narrowing of the cervical spine or any disc degeneration
- CT or MRI scan to visualize nerves and discs
- Myelogram, for those unable to undergo an MRI. Dye is injected into the spine and then an X-ray taken.
Treatment options depend on the duration and severity of symptoms. If symptoms are mild to moderate, the physician may recommend:
- Pain medicine
- An anti-inflammatory such as aspirin, ibuprofen or naproxen
- Cervical collar or brace
- Exercises to strengthen the neck and increase neck flexibility
- Physical therapy, including heat/cold packs, massage or electrical stimulation to reduce muscle tension
- Chiropractic manipulation
If left untreated, cervical canal stenosis can result in partial or permanent paraplegia. If symptoms persist, are severe or X-rays show the spinal cord or nerves are being compressed, surgery may be recommended. Surgical procedures may be done individually or in combination. They include:
- Laminectomy, opening the vertebra to relieve the pressure on the spinal cord
- Discectomy, removal of a herniated or bulging disc that may be pressing on nerve roots
- Spinal fusion, joining (fusing) vertebrae together to provide stability to the spine
Always make an appointment with your doctor to verify the symptoms for cervical canal stenosis before pursuing any form of treatment. He or she may recommend exercises, mild medication, and physical therapy before suggesting extreme measures such as surgery.