Cervical Stenosis Treatment Options

For patients with mild to moderate symptoms, non-surgical treatments can help manage discomfort and slow the progression of the condition. These conservative therapies aim to reduce inflammation, improve spinal alignment, and alleviate pressure on the spinal cord and nerves.

Activity Modification

Patients are advised to:

• avoid repetitive movements that worsen symptoms, such as excessive neck extension, prolonged sitting, or improper posture.
• make ergonomic adjustments, such as a properly positioned computer monitor, supportive neck pillows, and chairs with lumbar support.
• engage in low-impact exercises like swimming or walking to maintain spinal mobility without excessive stress on the cervical spine.

Physical Therapy

Physical Therapy involves strengthening the muscles that support the cervical spine. A tailored program typically includes strengthening exercises that target the neck, upper back, and shoulder muscles to improve stability and support, posture correction to help patients develop better spinal alignment and reduce pressure on the affected areas, stretching exercises to improve flexibility and reduce muscle tightness, and balance and coordination training for patients experiencing myelopathy (spinal cord compression) to prevent falls and improve movement control.

Pain Management

• Over-the-counter medications like nonsteroidal anti-inflammatory drugs (NSAIDs) to reduce inflammation and pain. In some cases, prescription medications such as muscle relaxants or neuropathic pain relievers (e.g., gabapentin) may be recommended.
• Epidural steroid injections involve corticosteroid injections into the spinal canal to reduce inflammation and alleviate nerve compression-related pain, providing temporary relief but not curing the underlying stenosis.
• Heat and cold therapy can help manage pain and inflammation.

While non-surgical approaches can be effective for symptom relief, they do not address the structural narrowing of the spinal canal. If symptoms persist or worsen, surgical treatment may be necessary.

Surgical intervention is considered when non-surgical treatments are no longer effective, or if spinal cord compression is causing significant neurological deficits. Dr. Mathew Cyriac specializes in advanced minimally invasive and motion-preserving surgical techniques, which allow for faster recovery and reduced disruption to surrounding tissues. The type of surgery performed depends on the cause, severity and location of the stenosis.

Anterior cervical discectomy and fusion (ACDF)

ACDF is a common minimally invasive procedure for relieving nerve or spinal cord compression due to a herniated disc or bone spurs. During this surgery, the affected disc is removed through an incision in the front of the neck, a bone graft or synthetic spacer is placed in the empty space to maintain spinal height, and the adjacent vertebrae are fused together to stabilize the spine and prevent further narrowing. This procedure is highly effective at relieving pain and neurological symptoms but results in some loss of motion in the treated segment.

Cervical disc replacement (artificial disc replacement)

For select patients, cervical disc replacement may be a better alternative to ACDF. Instead of fusing the vertebrae, an artificial disc is implanted to maintain natural spinal motion, reduce the risk of degeneration in adjacent spinal segments, and provide long-term symptom relief without sacrificing mobility.

Cervical laminoplasty

Laminoplasty is a motion-preserving alternative to laminectomy, suitable for multi-level cervical stenosis. Instead of removing the lamina entirely, the lamina is reshaped and repositioned to expand the spinal canal. This preserves spinal movement while relieving pressure on the spinal cord. It is particularly useful for patients who require decompression across multiple spinal levels and want to avoid fusion.

For patients who are candidates for less invasive procedures, Dr. Mathew Cyriac offers minimally invasive decompression techniques, including microdiscectomy, which removes herniated disc material pressing on nerves, foraminotomy, which widens the openings (foramina) where spinal nerves exit to relieve nerve compression, and endoscopic surgery, which uses small incisions and a camera to remove bone spurs or disc fragments with minimal tissue disruption. Minimally invasive techniques offer quicker recovery times, reduced pain, and smaller incisions, allowing patients to return to daily activities sooner.

The recovery period varies depending on the type of surgery performed and the patient’s overall health. Post-surgical rehabilitation is critical to a successful recovery.

With proper treatment, most patients experience significant relief from pain and symptoms, improving their ability to perform daily activities. Early diagnosis and intervention are crucial for preventing long-term complications such as permanent nerve damage or loss of function.