Cervical Spinal Stenosis, Myelopathy and Radiculopathy

The cervical spine is the upper part of the spinal column in the neck. The spinal cord and nerve roots (which supply function to the arms) travel through the spinal canal down to the upper back. As the spine ages and degenerative disc disease develops, bone spurs called osteophytes can cause compression of the spinal cord (spinal stenosis) or compression of a single or multiple nerve roots.

If the spinal cord is compressed, cervical myelopathy symptoms can develop. Patients can feel their hands weaken or clumsy. They can begin dropping things, difficulty with fine motor function such as writing, feeling off balance, uncoordinatedand legs feel stiff or heavy. MRI scans often show an area of narrowing of the cervical spinal canal with compression of the spinal cord like an hourglass narrowing. Mild spinal stenosis can be monitored, but patients with more serious spinal cord symptoms mayrequire surgery. Surgical intervention may be treated from the front (anterior) or from the back (posterior). Anterior cervical discectomy or disc replacement can be performed through a small incision from the front. Or multilevel stenosis may require a posterior laminectomy or laminoplasty from the back. Most patients experience reduction or resolution of their pre-operative symptoms.

When arm pain is the predominant symptom, usually one or more cervical levels may have bone spurs which put pressure on a specific nerve root. Symptoms of arm pain from the shoulder to the hands may be accompanied by numbness, tingling and muscle weakness. Conservative therapy may resolve these symptoms. In a small percentage of patients, minimally invasive anterior (front) or posterior (back) surgery can relieve these symptoms. Usually fast recovery in 6-8 weeks is anticipated.