Cervical Spinal Stenosis

The natural aging process is far and away the main cause of spinal stenosis. Osteoarthritis is the most common natural reaction of the body to disease and injury and is more common as we age. Osteoarthritis is the most common cause of cervical spinal stenosis.

With age, the jelly-like discs that cushion the vertebrae in the spine begin to dry out. It becomes obvious as we lose height. Arthritic bone spurs puts pressure on the facet joints (the connections between he vertebrae) causing degenerative changes in the joints and lead to arthritis.

Arthritis can also cause the ligaments around the joints to thicken and enlarge, decreasing space in the spinal canal for nerves to pass through. The cartilage that protects joints wears away as well. Too much wear leads to bone-on-bone rubbing. To compensate for the missing cartilage, the body may grow bone in the facet joints. Bone overgrowth is called spurs, and their formation further contributes to the narrowing of space in the spinal canal for nerves to pass through. Once the space within the spinal canal becomes too cramped, pain can ensue.

Cervical spinal stenosis can also be caused by other conditions as well. Those include:

• Spondylosis or spondylolisthesis (slipped vertebra)
• Injury or fracture
• Rheumatoid arthritis or ankylosing spondylitis

The symptoms of cervical spinal stenosis can vary depending on the severity of the condition and the specific structures being compressed. Patients with cervical spinal stenosis may have the following symptoms:

• Localized neck pain
• Compression of the nerve roots can cause radiculopathy which is pain, tingling, and numbness that radiates down the arms and into the fingers
• As the spinal stenosis progresses, the spinal cord can become compressed causing weakness, coordination and balance problems causing an unsteady gait, and a tendency to stumble or fall
• Loss of control fine motor skills that can lead to the inability to hold objects, button a shirt or affect writing.
• Sensory changes like numbness, tinging and loss of feeling in the arms, hands or legs
• Loss of position sense, meaning the inability to know what position arms are in if they are not visible.
• Worsening of symptoms with some activities like walking, prolonged standing or neck extension.

Chicago spine surgeon Dr. Kern Singh will review your medical history, inquire about your symptoms, their duration, and how they affect your life. He will perform a full neurological evaluation checking range of motion and flexibility, strength and reflexes.

He will order an X-ray of the cervical spine to check for fractures and degenerative changes of the spine. The best imaging to check for a cervical spinal stenosis is an MRI, which can show details of soft tissues like discs and nerves well.  An MRI is helpful if conservative management has not improved symptoms, or if the patient has red flag symptoms that require immediate evaluation. With all this information, Dr. Singh will render his diagnosis and explain your condition to you.