Cervical spinal stenosis surgery is a surgical treatment used to solve problems of spinal stenosis in the cervical part of the spine. Before even talking about this surgical procedure it is very important to understand what cervical spinal stenosis is first.
Cervical spinal stenosis is characterized as a medical condition in which the spinal column narrows at the cervical region of the spine. The stenosis can occur due to various causes. Whatever, the cause of the spinal stenosis is, it is characterized by pressure in the spinal cords and the nerves roots that originate in this part of the spine. Cervical spinal stenosis, together with lumbar spinal stenosis, is the most common type of spinal stenosis.
Causes of cervical spinal stenosis
As mentioned, when a condition or event occurs that shrinks the space within the spinal canal, it is called spinal stenosis. When the spinal column narrows, the spinal cord and the nerve roots will be under constant pressure. Eventually, the stress and pressure on the spine caused by spinal stenosis leads to symptoms. Some people are even born with a narrower spinal canal than normally. Spinal stenosis is typically a result of the following reasons:
- Herniated disc – This is a medical condition characterized by weak and even torn discs that pop out, compressing this way the spinal nerves. Normally, the vertebral column is made up of vertebrae. In a healthy spine, cartilage discs separate the vertebrae. They act like cushions to absorb shock and prevent damage to the vertebrae. Whenever an injury or a degeneration of these cartilage discs occur, they tend to get weak and even tear down, leading eventually to a disc herniation. A disc herniation can occur in the cervical part of the spine.
- Injuries of the spine – The cervical spine is very vulnerable and easily injured due to a trauma, fall or car accidents. Any injury or trauma to the cervical spine can lead to cervical spinal stenosis.
- Thickening of the ligaments around the cervical region – If for any reason the ligaments that surround the cervical spine thicken or stiffen, spinal stenosis can occur.
- Tumors – Any tumor of the spine can lead to narrowing of the spinal canal, especially when the abnormal tissue grows inside of the spinal cord.
- Bone overgrowth – In certain diseases, bone overgrowth occurs. Paget’s disease and osteoarthritis are examples of this. These bone overgrowths will end up narrowing the space of the spinal cord, leading to various symptoms of spinal stenosis.
Signs and symptoms of cervical spinal stenosis
It is possible for cervical spinal stenosis to sometimes be asymptomatic. On the other hand, some patients can experience severe symptoms due to the condition, making even the simplest daily activities impossible. Depending on the cause and location of the spinal stenosis, symptoms will vary for each individual case.
With cervical spinal stenosis, signs and symptoms tend to start gradually, worsening over time. The following are typical signs and symptoms of the condition:
Diagnosing cervical spinal stenosis
Imaging tests are necessary when it comes to diagnosing cervical spinal stenosis. Routinely ordered tests include:
Since cervical spinal stenosis shares many similar symptoms with other medical conditions, it can be very difficult to diagnose. This is why imaging test are needed for a doctor to identify narrowing in the spinal canal.
Treatment for cervical spinal stenosis
The treatment for cervical spinal stenosis always depends on what is causing the condition, the location, as well as the severity of the symptoms experienced by the patient.
First, conservative treatment is suggested. Painkiller medications play an important part of the conservative treatment for cervical spinal stenosis. You can choose from a large range of painkillers available, depending from what works best for you, NSAIDs, opioids, etc. Muscle relaxants are also routinely prescribed when treating cervical spinal stenosis conservatively as they will help the muscles relax, relieving this way the pain and other symptoms.
Physical therapy also plays an important role when treating a cervical spinal stenosis. In order to relieve the pain, it is very important to strengthen the muscles in the back, especially the upper back, the neck and the shoulders. Working on the spine's flexibility and stability is also extremely important to maintain a person's ability to move and balance.
Another possibility for treatment is steroid injections. They will help to reduce inflammation in the spinal column, therefore relieving pressure on the spine and nerve roots. Pain will also be relieved.
Surgery is the last-resort treatment plan for cervical spinal stenosis, and is only used when other conservative treatment options fail to relieve and control severe symptoms. The goal of the cervical spinal stenosis surgery is to relieve the pressure on the nerve roots and on the spinal cord by increasing the space in the spinal canal that has been narrowed.
These are some of the types of cervical spinal stenosis surgery:
- Laminoplasty – This is a surgical procedure used for the treatment of cervical spinal stenosis surgery which consists of opening up the spinal canal by creating a hinge on the lamina of the damaged vertebrae.
- Laminotomy – This cervical spinal stenosis surgery includes removing only a part of the lamina. In general, a hole just big enough to relieve the pressure is carved in the particular spot where the narrowing occurs.
- Laminectomy – This surgical procedure involves removing the lamina (the back part of the vertebrae) of the affected vertebrae.
Surgical treatment of the spinal stenosis surgery is not always the right treatment. In some cases, the signs and symptoms have had no improvement after the surgery, while in other cases the signs and symptoms of spinal stenosis surgery did get worse after the surgical procedure.
Like any other surgical procedure, cervical spinal stenosis surgery has its own risks and possible complications. Surgical risks include:
- Infection of the surgical area
- Blood clots in a large vein
- Tearing of the membrane that covers the spinal cord
- Neurological deterioration
When performed by professional surgeons the possibility of surgical complications is very low. Current surgical techniques used for cervical spinal stenosis also try to minimize the exposure and damage to the nearby tissue surrounding the cervical spine. Surgeons aim to preserve the spine ligaments and facet capsules while performing the surgery. By doing so, the chances of developing a degeneration or stenosis in the future are reduced.