Cervical Spinal Stenosis

Cervical spinal stenosis occurs when the spinal canal in the neck narrows, putting pressure on the spinal cord and nearby nerves.
This narrowing often develops gradually over time and can lead to neck pain, arm symptoms, and in severe cases, balance or walking difficulties.

When left untreated, cervical spinal stenosis may progress to a more serious condition called cervical myelopathy, where the spinal cord itself is compressed.

Cervical spinal stenosis is most often the result of age-related degenerative changes in the spine, though it can also be caused by trauma or structural abnormalities.

Common causes include:

• Bone spurs (arthritis): overgrowth of bone narrows the spinal canal.
• Herniated discs: disc material bulges into the canal, crowding the nerves or spinal cord.
• Thickened/Ossified ligaments: ligaments along the spine may stiffen and enlarge with age, reducing space around the spinal cord.
• Degenerative disc disease: loss of disc height brings vertebrae closer together, further narrowing the canal.
• Congenital narrowing: some individuals are born with naturally narrow spinal canals.
• Trauma or injury: fractures or dislocations can quickly cause dangerous narrowing.

Cervical spinal stenosis symptoms can range from mild to severe, depending on how much pressure is placed on the spinal cord or nerve roots.

• Neck pain that may feel like stiffness, aching, or sharp discomfort.
• Radiating pain into the shoulders, arms, or hands, sometimes described as burning or electric-like.
• Numbness or tingling (“pins and needles”) in the arms or hands.
• Weakness in the arms or hands, leading to difficulty gripping or lifting objects.
• Balance and coordination problems, such as tripping or unsteady walking.
• Loss of fine motor skills, including handwriting changes or clumsiness with buttons or zippers.
• Severe or urgent symptoms: sudden bladder or bowel dysfunction or rapidly worsening walking ability — these require immediate medical attention.

Early diagnosis is key to preventing long-term spinal cord or nerve damage.
Dr. Fried uses a comprehensive approach that includes:

• Medical history: to understand symptoms, their progression, and lifestyle factors.
• Physical and neurological examination: to evaluate reflexes, muscle strength, sensation, and coordination.
• Imaging studies:
  • X-rays: to detect alignment problems, arthritis, or bone spurs. 
  • MRI: the most effective tool for visualizing narrowing and soft tissue compression.
  • CT scans: used for detailed bone evaluation, especially in complex cases.
     

The treatment approach depends on the severity of symptoms and the degree of spinal cord or nerve compression.
Dr. Fried prioritizes non-surgical care first, with surgery reserved for cases of progressive symptoms or neurological decline.