OVERVIEW

What is cervical spinal stenosis?

Cervical spinal stenosis refers to a series of syndromes caused by chronic compression of the spinal cord and nerve roots within the spinal canal due to a narrowing of the cervical spinal canal diameter below normal levels.

Symptoms may include dizziness, headaches, neck pain, arm pain, numbness and weakness in the upper limbs, and in severe cases, limb weakness and bladder/bowel dysfunction. Treatment typically involves medication to relieve symptoms and surgical intervention to alleviate the stenosis.

Is cervical spinal stenosis common?

Yes.

Aside from congenital factors, most cases occur in middle-aged and older individuals due to degenerative changes in the cervical spine.

Is cervical spinal stenosis the same as cervical spondylosis?

Not entirely equivalent.

The former refers to cervical spinal canal narrowing caused by various factors. While cervical degenerative changes leading to disc herniation are a common cause of cervical spinal stenosis, many other causes exist. The latter refers to syndromes caused by cervical degenerative changes, including cervical disc herniation, cervical osteophyte formation, facet joint hypertrophy, ligamentum flavum thickening, etc.

SYMPTOMS

What are the manifestations of cervical spinal stenosis?

Depending on the severity of the condition, patients with cervical spinal stenosis may exhibit varying symptoms. Mild cases may be asymptomatic or only present with dizziness, neck, shoulder, and upper limb discomfort.

Severe cases compressing the spinal cord can cause limb numbness and weakness, followed by lower back weakness, heaviness in the legs, gradually progressing to lower limb weakness, ataxic gait, or bowel and bladder dysfunction.

How does cervical spinal stenosis progress?

Cervical spinal stenosis is mostly a slowly progressive disease, but accidental neck injuries may lead to sudden worsening.

What serious consequences can cervical spinal stenosis cause?

Severe cervical spinal stenosis can compress the spinal cord, leading to quadriplegia, numbness, and bowel and bladder dysfunction.

CAUSES

How Does Cervical Spinal Stenosis Occur? What Are the Causes?

In normal adults, the average anteroposterior diameter of the spinal canal is 17–18 mm. The spinal canal contains the spinal cord and nerves, serving as the communication pathway for the brain to control limb movement, receive sensory input, and regulate organ activity. When the anteroposterior diameter of the spinal canal decreases to a certain extent, symptoms of nerve root and spinal cord compression may occur.

Congenital developmental abnormalities of the cervical spinal canal, degenerative changes in the cervical spine, cervical disc herniation, ossification of the posterior longitudinal ligament, hypertrophy/ossification of the ligamentum flavum, and other conditions can lead to spinal stenosis, impairing blood supply to the spinal cord and causing symptoms of nerve root and spinal cord compression.

Who Is Prone to Cervical Spinal Stenosis?

The most common cause of spinal stenosis is degenerative changes in the cervical spine. Therefore, individuals who frequently engage in activities requiring a forward head posture (such as prolonged computer, phone, or TV use; long hours of driving), those who frequently lift heavy objects, and those with a history of repeated neck injuries are more susceptible to cervical spinal stenosis.

DIAGNOSIS

How is cervical spinal stenosis diagnosed?

Clinicians can diagnose it based on the patient's symptoms and signs, combined with imaging studies showing a significant reduction in the anteroposterior diameter of the cervical spinal canal.

What tests are needed to determine the cause of cervical spinal stenosis, and why?

For patients suspected of having cervical spinal stenosis, imaging studies are required to confirm the presence of stenosis and identify the cause. Key tests include:

• Cervical X-ray: Cost-effective and convenient, it helps assess cervical curvature changes and bone spurs.

• Cervical CT or MRI: Accurate for measuring the anteroposterior diameter of the spinal canal, confirming stenosis, and determining the cause. MRI is particularly useful for diagnosing spinal canal stenosis and spinal cord compression, as it can detect spinal cord signal changes and nerve compression.

What precautions should cervical spinal stenosis patients take before an MRI?

• MRI is a common imaging method with high resolution and no radiation, making it relatively safe.
• Patients must ensure no metal objects (e.g., nails, plates, dental implants, prosthetics, stents) are in their body and remove all metal items (watches, hairpins, keys, coins, belts, phones, etc.) before entering the scanning room.
• The procedure lasts several minutes to tens of minutes, involves noise, and occurs in a confined space, which may cause anxiety. Patients should stay relaxed, remain still, and cooperate with technicians. Earplugs or a companion may be used if necessary.

What conditions should cervical spinal stenosis be differentiated from?

Cervical spinal stenosis must be distinguished from other conditions causing limb numbness or weakness, such as myelitis, intraspinal space-occupying lesions, peripheral neuropathy, and motor neuron disease.

TREATMENT

Which department should I visit for cervical spinal stenosis?

Generally, you can consult Neurology, Spinal Surgery, or Orthopedics.

Can cervical spinal stenosis heal on its own?

No.

Does cervical spinal stenosis require hospitalization?

Mild cases usually do not require hospitalization. However, severe spinal cord compression or the need for surgical intervention may necessitate admission.

How is cervical spinal stenosis treated?

Mild cases can be managed conservatively with medications or physical therapy to alleviate symptoms. However, persistent spinal cord or nerve root compression requires surgical treatment to enlarge the spinal canal and relieve pressure for optimal results.

What are the potential complications or risks after cervical spinal stenosis surgery?

Postoperative risks may include infection at the surgical or bone graft site, damage to the recurrent laryngeal or superior laryngeal nerves, hematoma, difficulty swallowing, hyperextension paralysis or vibration-related paralysis, narrowing of the intervertebral space, spinal cord or dural injury, vascular injury, poor vertebral healing, etc.

What should be noted after cervical spinal stenosis surgery?

• Close monitoring is essential to detect any discomfort or complications early.
• Temporary neck immobilization is often required. Patients should remain calm, rest, tolerate some surgical pain, and follow medical instructions strictly.
• Start with a liquid diet; if swallowing difficulties persist, nasogastric tube feeding may be necessary.

Is follow-up required after cervical spinal stenosis surgery?

Yes.

The follow-up schedule and specific tests depend on the type of surgery and the patient’s condition.

DIET & LIFESTYLE

What should patients with cervical spinal stenosis pay attention to in their diet?

There are no special precautions. Patients should maintain healthy eating habits.

What should patients with cervical spinal stenosis pay attention to in daily life?

Patients with cervical spinal stenosis should pay special attention to protecting the cervical spine, quit smoking, avoid cold exposure, avoid lifting heavy objects, and prevent neck injuries.

At the same time, strengthen neck care, increase physical exercise, maintain a regular daily routine, and use a cervical pillow to elevate the neck during nighttime rest.

PREVENTION

Can cervical spinal stenosis be prevented?

In most cases, yes.

Most cervical spinal stenosis stems from degenerative cervical changes. A healthy lifestyle can help reduce cervical degeneration, including:

• Perform slow flexion, extension, lateral bending, and rotation exercises for the neck several times in the morning and evening to strengthen neck muscles;

• Avoid prolonged forward head posture. If unavoidable due to work, change positions every hour or so. Correct poor work and lifestyle habits, such as reading or watching TV in bed;

• Rest the neck in a neutral position. Using a cervical pillow to elevate the neck by about 10cm is recommended;

• Avoid neck injuries;

• Protect the neck from cold, dampness, and direct exposure to fans or air conditioning in summer;

• Quit smoking and prevent upper respiratory infections.