2. Spinal Stenosis of the Neck – Diagnosing & Treating the Condition Spinal stenosis of the neck is a spinal condition that refers to a narrowing of the cervical region of the spinal column. Though a number of factors can lead to a narrowing of this area of the spine – including congenital defects and the presence of spinal tumors – it most commonly results from a degenerative spinal condition. As an individual grows older, the anatomical elements of the spine are prone to deterioration from the stress of continually supporting weight and the responsibility of allowing for movement. Spinal deterioration can lead to a number of spinal conditions, including osteoarthritis, degenerative disc disease, and spondylolisthesis, among others. If one of these conditions causes a bulging or herniated intervertebral disc, misaligned vertebra, osteophyte, or other anatomical abnormality to encroach the cervical region of the spinal column, the patient is said to have spinal stenosis of the neck.
3. Symptoms of Spinal Stenosis of the Neck In and of itself, spinal stenosis is not typically painful. If the spinal canal narrows to the point that the spinal cord or a nerve root becomes compressed, the patient may then experience discomfort. Though most individuals associate a compressed nerve in the cervical spine with localized neck pain, a variety of symptoms can actually be experienced in seemingly unrelated areas of the body. This occurs because the spine is a highly innervated part of the body and, in conjunction with the other components of the central nervous system, is responsible for controlling sensation and movement throughout the body. As a result, symptoms may traverse the length of the nerve to cause pain, numbness, tingling, and/or muscle weakness in the neck, upper back, shoulders, and/or arms.
4. Diagnosing Spinal Stenosis of the Neck A doctor or spine specialist can use a number of different techniques to diagnosis cervical spinal stenosis. Individuals should be prepared to answer a number of questions when visiting a doctor regarding neck pain. The doctor will likely inquire about the patient’s symptoms, how long he or she has been experiencing them, and how severe they have been. Questions regarding family history may also be asked, as some spinal conditions can run in families. The doctor will also ask about the patient’s personal medical history and whether he or she currently participates or ever has participated in high-impact sports such as football or gymnastics, and whether he or she has recently suffered a slip and fall or endured any other type of injury. A physical examination may prove crucial, especially if a patient is experiencing neuralgia, or pain and discomfort that travel along the length of the compressed nerve. By palpating the spine, the doctor may be able to determine if the source of the individual’s arm pain, for instance, is actually being caused by spinal stenosis in the neck. The doctor will also check the patient’s reflexes and muscular strength. Oftentimes, the only true way to diagnose a spinal condition is through the use of diagnostic imagery, such as an MRI, CT scan, or X-ray. These tests provide the doctor with a clear image of the inside of the patient’s spine and can provide insight as to which anatomical element of the spine, if any, is compressing a nerve root.
5. Treating Spinal Stenosis of the Neck Once a doctor or spine specialist has determined that a patient is suffering from cervical spinal stenosis, a regimen of noninvasive treatments will be prescribed. Among the most common conservative, noninvasive treatments are: Medication – Many patients are able to find adequate relief by utilizing over-the-counter, non-steroidal anti-inflammatory drugs (NSAIDs). NSAIDs, such as naproxen and ibuprofen, help to reduce pain and inflammation by blocking the body’s production of certain enzymes. Because of other medical conditions or medications, some patients may be unable to take NSAIDs. These individuals may be prescribed muscle relaxants or pain relievers. Hot/cold therapy – Applying a heating pad to the neck helps to increase circulation at the site of the spinal nerve compression. Increased circulation can help to speed the healing process and may provide some patients with relief from the symptoms of spinal stenosis. Alternately, applying a cold pack to the neck can help to reduce inflammation and provide a numbing effect against pain. Some doctors may recommend that patients use either a heating pad or cooling pack exclusively while others recommend that patients alternate between the two. Physical therapy – Working with a physical therapist can help patients increase specific muscles in the neck and back to provide better support to the spine. This increase in muscle strength can ease some of the burden that is being placed on the affected nerve. Physical therapists may also employ other treatment methods, such as transcutaneous electrical nerve stimulation (TENS), deep tissue massage, and posture modification exercises, among others. Lifestyle modifications – If a patient is overweight, uses tobacco products, and/or abuses alcohol, his or her doctor may encourage them to take on healthier habits. Being overweight forces the spine to work extra hard and can add even more pressure to the affected spinal nerve. The chemicals in alcohol and tobacco can prohibit blood circulation and may lead to dehydration of the intervertebral discs and other areas of the body. Having an overall healthy lifestyle can lead to a healthy spine.
6. Surgical Treatment for Spinal Stenosis of the Neck If a patient finds little to no relief after several weeks or months of following a noninvasive treatment regimen, his or her doctor may recommend surgery. The goal of surgery for spinal stenosis is to decompress the affected nerve root and is typically accomplished via open spine surgery. During this type of surgery, a large incision is made in the neck and the spinal element that is causing compression is removed in its entirety. A bone graft and hardware are then typically utilized to lend stability to that area of the spine and to restrict further movement. Some patients may choose to undergo a minimally invasive procedure in lieu of open spine surgery. These procedures are performed on an outpatient basis and utilize an endoscope to gain access to the affected area of the spine. Unlike with open spine surgery, only the portion of the spinal anatomy that is causing nerve compression is removed. For instance, instead of removing the entire intervertebral disc that has herniated or become misshapen, the surgeon will only remove the disc material that is directly compressing the spinal nerve.
7. Conclusion Open spine surgeries and minimally invasive procedures each come with a number of risks and benefits. Before consenting to any type of surgical procedure for spinal stenosis of the neck, patients should thoroughly discuss potential complications with their doctor. Patients may also want to pursue a second or third opinion to ensure the proper diagnosis was formed and that all noninvasive treatments have been attempted.
