Cervical Stenosis and Myelopathy

Cervical spinal stenosis is a narrowing of the spinal canal in the neck area, which can put pressure on the spinal cord and nerves. This can cause symptoms like neck pain, numbness, tingling, or weakness in the arms, hands, and legs. In severe cases, it can lead to cervical myelopathy, where the spinal cord itself is compressed, causing balance problems, falls, difficulty walking, and even loss of bladder or bowel control.

Non-surgical treatments aim to manage symptoms and include cervical collars, traction, physical therapy, medications like NSAIDs or muscle relaxants, and rarely injections. These can provide relief for mild cases. However, if symptoms worsen or myelopathy develops, surgery may be necessary to prevent permanent nerve damage. MRI imaging can often distinguish between patients who can undergo a period of non-operative observation from those that need surgery because their myelopathy will progress without it.

Surgical options involve decompressing the spinal cord and nerves by removing bone, ligaments, or discs that are compressing them. Common procedures are laminectomy (removing the back or posterior part of the spine), foraminotomy (widening the nerve openings), or discectomy (removing disc material). Spinal fusion, using bone grafts or metal implants, may also be done to stabilize the spine after decompression. Minimally invasive techniques can be used for some patients. 

Surgery aims to relieve pressure, stabilize the spine, and prevent symptom progression. It generally provides good to excellent results, allowing patients to resume normal activities after a period of healing. We will spend time with you discussing goals, risks, and benefits of the various treatment options so that you can decide which treatment is appropriate.