Cervical Spinal Stenosis
From Prof. Dr. Murat Bezer

Cervical Spinal Stenosis

Discs, ligaments and joints called facets become deformed in time and some spills occur towards the main (ependymal) canal called the spinal cord in which there are nerves coming out of the brain and travelling towards our body. These facet joints and ligaments thicken and narrow down the ependymal canal, compressing the nerves. This is called cervical spinal stenosis.

This is in fact the result of a degenerative disease in the neck. It is one that develops slowly by the aging and deformation of the cervical vertebrae. However, spinal stenosis may also occur due to congenital causes, rheumatic diseases, and strong or repetitive impacts. The nerves in the spinal cord are damaged due to being compressed in the ependymal canal (cervical myelopathy). This leads to a loss of muscle strength due to the weakening of nerves that go to our arms and legs. It also causes a feeling of pins and needles, topognosis and numbness based on the damage suffered by the nerves. There may be intestinal and vesical problems as well.

In addition to these troubles, patients also suffer from neck pain and it usually constitutes the main complaint. The complaint of muscle weakness and numbness may increase in time. One needs to seek medical advice in such a case and take necessary precautions before it is too late. Because damaged nerve tissues are not as curable as other tissues. Therefore it may not always be possible to repair the damage.

If patients with such complaints get medical advice without delay, the doctor takes a medical history of the patient, performs a physical examination and asks for the necessary radiographic imaging studies like x-ray, computed tomography (CT Scan) and magnetic resonance imaging (MRI).

Patients that are diagnosed with cervical spinal stenosis are primarily put to non-surgical treatment methods. These methods are called conservative treatments. The doctor decides whether the treatment should be surgical or conservative based on the patient’s age, the location and the level of stenosis. There may be a medication treatment at the first stage in order to decrease the pain and irritation of the nerve tissue. The doctor may also require the patient to wear a neck brace for a short time in order to decrease the neck pain caused by muscle contractions. Physical therapy is also one of the non-surgical methods. There is also the method of spinal (epidural) injection which means the treatment of nerve irritation by injecting cortisone around the compressed nerves.

Surgical treatment comes into question if conservative treatments fail and/or the spinal stenosis is in the most serious stage. The tissues that bulge out to the ependymal canal can be removed by surgery. This is called (cervical) decompression. The intervertebral space between two vertebral bodies is adjusted to its normal level and the vertabrae are fused together. The compressed spinal cord and the nerves are therefore relieved. The purpose of surgery is to eliminate the nerve compression and to prevent it from further deterioration. Since the nerve tissues have a relative capability of getting better, the surgery provides a healthier spine than that before.