Cervical Spine Stenosis

Condition

Cervical Spine/ Canal Stenosis

Causes

Overgrowth of boneWear and tear damage from osteoarthritis on your spinal bones can prompt the formation of bone spurs, which can grow into the spinal canal. Paget's disease, a bone disease that usually affects adults, also can cause bone overgrowth in the spine.
Herniated disks The soft cushions that act as shock absorbers between your vertebrae tend to dry out with age. Cracks in a disk's exterior may allow some of the soft inner material to escape and press on the spinal cord or nerves.
Thickened ligaments The tough cords that help hold the bones of your spine together can become stiff and thickened over time. These thickened ligaments can bulge into the spinal canal.
Tumors Abnormal growths can form inside the spinal cord, within the membranes that cover the spinal cord or in the space between the spinal cord and vertebrae.
Spinal injuries Car accidents and other trauma can cause dislocations or fractures of one or more vertebrae. Displaced bone from a spinal fracture may damage the contents of the spinal canal. Swelling of nearby tissue immediately after back surgery also can put pressure on the spinal cord or nerves.

Symptoms

Neck pain
Pain, weakness, or numbness in the shoulders, arms, and legs.
Hand clumsiness.
Gait and balance disturbances.

Burning sensations, tingling, and pins and needles in the involved extremity, such as the arm or leg.
In severe cases, bladder and bowel problems.
Although rare, severe cases can also cause significant loss of function or even paraplegia.

Treatment

Pain relievers

Pain medications such as ibuprofen (Advil, Motrin IB, others), naproxen (Aleve, others) and acetaminophen (Tylenol, others) may be used temporarily to ease the discomfort of spinal stenosis.

Antidepressants

Nightly doses of tricyclic antidepressants, such as amitriptyline, can help ease chronic pain.

Anti-seizure drugs

Some anti-seizure drugs, such as gabapentin (Neurontin) and pregabalin (Lyrica), are used to reduce pain caused by damaged nerves.

Opioids

Drugs that contain codeine-related drugs such as oxycodone (Oxycontin, Roxicodone) and hydrocodone (Norco, Vicodin) may be useful for short-term pain relief.

Physical therapy

It's common for people who have spinal stenosis to become less active, in an effort to reduce pain. But that can lead to muscle weakness, which can result in more pain. A physical therapist can teach you exercises that may help:

Build up your strength and endurance
Maintain the flexibility and stability of your spine
Improve your balance

Steroid injections

Nerve roots may become irritated and swollen at the spots where they are being pinched. While injecting a steroid medication (corticosteroid) into the space around impingement won't fix the stenosis, it can help reduce the inflammation and relieve some of the pain.

Surgery

Decompression procedure With this procedure, needle-like instruments are used to remove a portion of a thickened ligament in the back of the spinal column to increase spinal canal space and remove nerve root impingement.The procedure is called percutaneous image-guided lumbar decompression (PILD). It has also been called minimally invasive lumbar decompression (MILD).
Laminectomy This procedure removes the back part (lamina) of the affected vertebra. A laminectomy is sometimes called decompression surgery because it eases the pressure on the nerves by creating more space around them.
Laminotomy This procedure removes only a portion of the lamina, typically carving a hole just big enough to relieve the pressure in a particular spot.
Laminoplasty This procedure is performed only on the vertebrae in the neck (cervical spine). It opens up the space within the spinal canal by creating a hinge on the lamina. Metal hardware bridges the gap in the opened section of the spine.
Minimally invasive surgery This approach to surgery removes bone or lamina in a way that reduces the damage to nearby healthy tissue.