Cervical spinal stenosis occurs when one or more bony openings (foramina) within the neck begin to narrow and reduce space for the nerves and/or spinal cord. While rare, cervical stenosis can progress to the point of causing spinal cord compression that results in neurological deficits, called myelopathy. Here’s how this condition can cause numbness, weakness, lack of coordination, pain, and other effects on the body.
How Cervical Stenosis with Myelopathy Progresses
Cervical stenosis with myelopathy is typically caused by degenerative changes within the cervical spine’s vertebrae, discs, and/or ligaments. Over time as the cervical spine continues to degenerate, either due to aging or perhaps an injury, one or more of the following may start to encroach upon the spinal canal where the spinal cord is located1:
- Bone spurs (osteophytes)
- Disc material that is leaking or broken off
- Thickened or buckling ligaments
Depending on the location and the extent of the spinal cord compression can affect what type of signs and symptoms may be experienced.
Signs and Symptoms of Cervical Stenosis with Myelopathy
In the beginning, the signs and symptoms of cervical stenosis with myelopathy may be too subtle to notice or could feel like typical neck pain and stiffness. If cervical myelopathy continues to progress, the signs and symptoms may worsen and include:
- Reduced fine motor skills. It may become more difficult to write, button a shirt, or type.
- Changes in gait. Walking may be unsteady or the legs could feel heavy.
- Numbness or tingling. Sensory deficits can occur anywhere below the level of spinal cord compression, such as in the arms, hands, legs, and/or feet.
- Weakness. Reduced strength in the arm(s) and/or leg(s) may also occur. If handgrip is affected, it could become more difficult to hold objects.
- Incontinence. Bowel and/or bladder dysfunction may occur in more severe cases of myelopathy.
It is important to note that cervical myelopathy commonly presents with hand numbness or clumsiness with little or no neck pain. If spinal cord compression continues to worsen, it could eventually result in more severe complications, such as complete loss of function or paralysis in one or more limbs.
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Diagnosing Cervical Stenosis with Myelopathy
Any new or unexplained numbness, weakness, and/or reduced coordination requires a medical evaluation. If your history and physical exam causes the doctor to suspect cervical stenosis with myelopathy, an MRI is likely to be requested. MRI imaging can potentially confirm stenosis and/or spinal cord compression. Electrodiagnostic testing may also be requested to determine whether or not the spinal cord is sending signals as expected.
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Treatment for Cervical Stenosis with Myelopathy
Cervical stenosis with myelopathy typically worsens over time. To reduce the risk for myelopathy to progress to the point of becoming permanently disabling, spinal decompression surgery may be recommended for patients who are good candidates for surgery. Before agreeing to any major surgery, be sure to ask your doctor about the potential benefits, risks, and any alternative treatments if available.
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