cervical spine

Cervical spinal stenosis

What is it ?

It is a narrowing of the cervical spinal canal, most often caused by natural aging of the cervical spine (a form of osteoarthritis). Bony outgrowths, bulging of the disc and thickening of the ligaments of the spine reduce the volume available for the spinal cord and nerve roots.

Clinical presentation

Cervical spinal stenosis (narrowing) is part of the natural evolution of aging and is therefore common in the normal population and progresses slowly. It often does not cause symptoms. One of the first signs of cervical spinal cord irritation (myelopathy) is the onset of gait disturbances: patients feel dizzy when walking. In more advanced forms, the stenosis causes greater difficulties in walking, with loss of strength, also difficulties in holding objects in the hands, difficulties in performing fine finger movements as well as writing. An MRI examination will be needed to confirm the diagnosis

When to consult a specialist?

Symptoms of cervical spinal stenosis develop usually slowly. Your general practitioner will ask for specialized surgical advice as soon as a chronic spinal cord irritation is clinically suspected: walking disability, fine hand movements difficulties in particular. Often, an examination by a neurologist will be requested.

Non surgical treatment

Nonsurgical treatment has a limited role when the diagnosis has been made. It will consist of physiotherapy exercises, ergotherapy, drug therapy, especially in non-operable patients.

Surgical treatment

The main problem is that the progression is slow, but there often is a stepwise deterioration (sudden loss of neurological function). In that case, surgical treatment will be highly recommended, especially if the MRI shows signs of irritation of the spinal cord (moderate or severe myelopathy). Various surgical techniques may be used, depending on the radiological and anatomical aspect, but the aim is to give room to the cervical spinal cord (see below a drawing of the laminoplasty technique).

Postoperative follow-up

Postoperative follow-up will depend on the surgical technique chosen. In general, patients start walking the same day or the day after the surgery. Physiotherapy may be recommended after a few weeks at the first postoperative follow-up.

Risks and complications

Again, this will depend on the surgical technique chosen which is adapted to each patient. In general, serious and neurological complications are very rare (close to 0%). Further information will be provided by the surgeon during the preoperative interview.