Orthopedic

Treatments

Most often symptomatic spinal stenosis occurs because of the development of degenerative conditions. This is commonly related to age, genetics, and wear and tear of daily living. There can be a congenital component to the stenosis. This typically involves the spinal canal and can crowd the spinal cord. When someone has congenital stenosis, they are much more prone to develop symptoms from relatively small degenerative conditions such as disc herniations or bone spur formation. The stenosis can then lead to spinal cord compression (myelopathy), which is usually painless, or to spinal nerve root compression (radiculopathy), which can be very painful.

Some people with cervical stenosis are asymptomatic, meaning they suffer no adverse affects. When myelopathy, or spinal cord compression, creates problems, the symptoms and physical findings may include hand clumsiness, clumsiness of gait, numbness in the hands, jumpy reflexes, a heavy feeling in the legs and difficulty walking, weakness, and, rarely, paralysis.

Most cases of cervical spinal stenosis occur in patients over the age of 50.

Your doctor will consider your medical history and symptoms and give you a physical examination, during which the doctor will look for limitations of movement in the spine, problems with balance, and signs of pain, as well as any changes in extremity reflexes, muscle weakness, sensory loss, or abnormal reflexes that may suggest spinal cord involvement.

After a physical examination, your doctor can use a variety of tests to get a closer look, including X-rays, MRIs, CT scans, CT myelogram, or bone scans.

Interventional treatments for cervical stenosis with myelopathy may include:

• Observation. If there are no symptoms or abnormal physical findings, then the patient does not have true "myelopathy," even though there is cervical stenosis and associated cord compression. In this situation, the usual treatment is simply waiting. This is because some patients with stenosis have no clinically significant problem and may not develop any problem in the future. However, if the stenosis (narrowing) is severe, then it may be appropriate to discuss the increased risk of spinal cord injury with sports or trauma.
• Physical therapy and/or exercises do not work for patients with a primary problem of cervical stenosis (cord compression) because these activities do not actually alleviate the underlying problem of spinal cord compression.
• Other Interventional Treatments such as non-steroidal anti-inflammatory drugs (NSAIDs), oral steroids, or injected steroids (epidural steroid injections and nerve root injections) may alleviate symptoms temporarily but do not alter the course of the disease.