Cervical Stenosis

Cervical stenosis typically develops over time due to age-related degeneration of the spine. However, other factors may contribute to its onset.

• Degenerative changes – The most common cause is osteoarthritis, which leads to the gradual breakdown of cartilage and the formation of bone spurs (osteophytes) that encroach on the spinal canal.
• Herniated discs – The intervertebral discs act as cushions between the vertebrae. With age, they can degenerate and bulge into the spinal canal, reducing the available space for the spinal cord.
• Thickening of ligaments – The spinal ligaments, which provide stability, can thicken and stiffen over time. This process, known as ligamentum flavum hypertrophy, can contribute to narrowing of the spinal canal.
• Congenital factors – Some individuals are born with a naturally narrow spinal canal, making them more prone to developing symptoms of cervical stenosis even at a younger age.
• Trauma or injury – Fractures, dislocations, or other injuries to the cervical spine can alter its structure, leading to narrowing and compression of the spinal cord.
• Tumors – Rarely, abnormal growths in the cervical spine can put pressure on the spinal cord, causing stenosis.

The symptoms of cervical stenosis can vary depending on the severity of the condition and whether the spinal cord or nerve roots are compressed.

• Neck pain – Patients often experience stiffness and aching in the neck. Pain may be mild at first but can become persistent and more severe over time.
• Radiculopathy (nerve compression symptoms) – Compression of spinal nerve roots can cause pain, numbness, tingling, or weakness in the shoulders, arms, and hands.
• Myelopathy (spinal cord compression symptoms) – When the spinal cord itself is compressed, patients may experience clumsiness, difficulty with fine motor skills (such as buttoning a shirt or writing), balance problems, and weakness in the legs.
• Loss of coordination – Some patients develop difficulty walking due to impaired nerve signals to the lower extremities.
• Bladder or bowel dysfunction – In severe cases, compression of the spinal cord can lead to loss of bladder or bowel control, which requires immediate medical attention.

The symptoms of cervical stenosis often progress gradually. However, in some cases, patients may experience a sudden worsening of symptoms, particularly if there is an acute injury or further narrowing of the spinal canal.

A thorough evaluation is necessary to diagnose cervical stenosis and determine the severity of spinal cord or nerve root compression.

• Medical history and physical examination – A spine specialist, such as Dr. Mathew Cyriac, will assess the patient’s medical history, including symptoms, duration, and any prior neck injuries. A physical exam evaluates strength, reflexes, sensation, and coordination to identify signs of nerve or spinal cord compression.
• X-rays – These imaging tests provide an overview of the cervical spine’s structure, showing degenerative changes such as bone spurs, disc height loss, and alignment abnormalities.
• Magnetic resonance imaging (MRI) – MRI is the most effective imaging tool for evaluating cervical stenosis. It provides detailed images of the spinal cord, nerve roots, discs, and soft tissues, helping to identify areas of compression.
• Computed tomography (CT) scan – A CT scan, sometimes combined with myelography (contrast dye injection), is useful for assessing bony structures and detecting severe narrowing of the spinal canal.
• Electromyography (EMG) and nerve conduction studies – These tests evaluate nerve function and can help distinguish between nerve root compression and other neurological conditions.