Cervical Spinal Stenosis

Understanding Spinal Stenosis of Cervical Spine

Cervical spinal stenosis marks the constriction of the spinal canal within the neck region, resulting in a variety of symptoms.

This narrowing can occur due to factors such as ageing, injury, or degeneration. The spinal canal, situated behind the vertebral blocks forming the spine, houses the spinal cord and nerve roots. When the canal is narrowed, compression of these structures can occur, resulting in cervical canal stenosis.

Additionally, as spinal nerves exit the cervical spinal canal through the intervertebral foraminae, narrowing of these passageways can lead to compression of nerve roots, known as cervical foraminal stenosis. 

Both conditions stem from similar underlying processes and often coexist. Collectively, they are known as cervical spinal stenosis, presenting with overlapping symptoms and requiring similar management approaches.

Typically, compression of the spinal cord itself causes cervical myelopathy, while compression of the nerve roots causes cervical radiculopathy. 

What Causes Cervical Spinal Stenosis?

Cervical spinal stenosis can emerge slowly over time as a natural consequence of ageing.  This is because the discs and structures in your neck undergo degenerative changes, similar to ‘wear and tear.’

Additionally, genetic predisposition and intervertebral disc prolapse can contribute to its onset.

As individuals age or experience excessive wear and tear, several processes occur:

1. The intervertebral discs lose water content, resulting in dehydration or desiccation. This causes the discs to decrease in height and bulge backward toward the spinal canal and intervertebral foramen.
2. The facet joints and ligaments which hold the vertebral bodies together, thicken and harden, further narrowing the spinal canal and intervertebral foramen.
3. Bone spurs, or osteophytes, may form, compressing nerves or the spinal cord.
4. Spondylolisthesis, characterised by the slipping forward of one spinal bone (vertebra) over another, can occur and contribute to compression.

These processes collectively compress the softest structures in the spine, namely the spinal cord, and nerves, resulting in cervical spinal stenosis.

Symptoms of Cervical Spinal Stenosis

Cervical spinal stenosis symptoms vary with the severity and extent of spinal cord and nerve compression.

• Neck pain or stiffness.
• Numbness, tingling, or weakness in the limbs
• Difficulty walking or maintaining balance
• Loss of fine motor skills or coordination
• Pain radiating down the arms or legs.
• Severe cases may affect bowel or bladder function.

These symptoms can progress gradually over time or suddenly, depending on the underlying cause of the stenosis and individual factors.

Diagnosis of Cervical Spinal Stenosis

Diagnosing cervical spinal stenosis typically involves a comprehensive evaluation by a healthcare professional, including:

• Medical history review to assess symptoms and risk factors.
• Physical examination to evaluate neurological function, strength, and reflexes.
• Imaging tests like X-rays, MRI, or CT scans are used to visualise the spinal canal and detect any narrowing or abnormalities.

These diagnostic tests help healthcare providers determine the extent of spinal stenosis and develop an appropriate treatment plan.

Cervical Spinal Stenosis Treatment Options 

Treatment for cervical spinal stenosis typically begins with conservative measures before considering surgical options.

1- Medication

Pain relief and inflammation reduction are often achieved through paracetamol and non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen, naproxen, or etoricoxib. Medicatyions targeting nerve pain may also be prescribed. 

2- Physiotherapy 

Physiotherapy, including acupuncture, are non-surgical options to relieve symptoms. Physiotherapy may involve heat or ice therapy, ultrasound, electrical stimulation, and massage to relax muscles and alleviate discomfort. An important component may also be exercises to strengthen the muscles around the cervical spine. 

3- Nerve Root Block (Transforaminal epidural)

In severe cases, a nerve root block, also known as a transforaminal epidural, may be helpful. This is particularly helpful when only one nerve is compressed, and the injection can assist with both the diagnosis and management of a compressed nerve. 

4- Surgery

In severe or unresponsive cases, surgery may be necessary to relieve spinal cord or neural pressure and stabilise the spine.

 Surgical options include:

• Anterior cervical decompression and fusion
• Cervical arthroplasty (artificial disc insertion)
• Cervical laminectomy
• Posterior cervical decompression and fusion

Each surgical procedure aims to alleviate compression and improve spinal stability. 

Dr Sherief will suggest the best course of treatment tailored to the severity of your condition and your individual circumstances.

Consult Dr Sherief Elsayed for Cervical Spinal Stenosis treatment in Dubai

Seek treatment for Cervical Spinal Stenosis from Dr Sherief Elsayed  an esteemed spine specialist in Dubai. With extensive expertise and training, Dr Sherief Elsayed  is renowned for his exclusive focus on spinal conditions. 

Dr Sherief Elsayed offers advanced treatment options as one of the few surgeons worldwide skilled in Robot-assisted Spine Surgery. Experience exceptional spinal health care with Dr Sherief Elsayed, the top spine surgeon in Dubai.