Spinal Stenosis in the Neck

Spinal Stenosis in the Neck

Spinal stenosis in the neck occurs when a portion of the cervical spinal canal becomes narrowed. This is most commonly caused by anatomical debris that has been produced as a result of a degenerative spine condition, such as spinal arthritis or a herniated intervertebral disc. Just as there are a number of degenerative conditions that can cause spinal stenosis, so too are there a number of ways to treat the condition.

Anatomy of the SpineIn order to thoroughly understand what causes spinal stenosis in the neck, it is first necessary to have a basic understanding of the spinal anatomy. The spine’s major components include:

• Vertebrae – These are the bone segments that house and protect the spinal cord. Most

individuals have 33 vertebrae, 24 of which articulate. The vertebrae in the cervical spine are smaller than those found in the thoracic and lumbar regions and are primarily tasked with supporting the weight of the head.

• Vertebral foramina – At the center of each vertebra is an opening called a vertebral foramen, which is the space through which the spinal cord passes. Collectively, the vertebral foramina are referred to as the spinal canal. Spinal stenosis affects this portion of the spine’s anatomy.

• Facet joints – These joints connect adjacent, articulating vertebrae to one another. The facet joints are what enable us to bend and otherwise move our necks and backs.

• Intervertebral discs – Positioned between each of the articulating vertebrae are shock absorbing “pads” called intervertebral discs. These structures are tasked with absorbing the impact that is placed on the spine and are also responsible for providing cushioning to the vertebrae and preventing them from rubbing against one another.

Causes of Spinal Stenosis in the Neck

Now that the major anatomical components of the spine have been outlined, it’s time to discuss the various degenerative conditions that can cause spinal stenosis in the neck. It should be noted that degenerative spine conditions are usually the result of nothing more than the natural aging process. Over time, the spine can begin to break down because of the wear and tear that is continually placed upon it, in turn causing us to have “bad backs” by the time we reach middle age. What we refer to as a “bad back” is more often than not a symptom of a degenerative spine condition.

Causes of Spinal Stenosis in the Neck

The most common degenerative conditions that lead to spinal stenosis in the neck include:

• Herniated discs – A herniated disc occurs when the outer wall of an intervertebral disc (called the annulus fibrosus) develops a crack or tear. In turn, this allows the disc’s inner content (called the nucleus pulposus) to escape and enter the spinal canal.

• Bulging discs – Though the terms are often used interchangeably, herniated and bulging discs are actually two unique conditions. In the case of a bulging disc, the annulus fibrosus has weakened but remains intact. However, the annulus fibrosus is no longer strong enough to contain the nucleus pulposus within its normal boundary and the disc is susceptible to bulging to one side. If the misshapen disc invades the spinal canal, then the patient is said to have spinal stenosis.

• Facet disease – Also commonly referred to as spinal arthritis or facet syndrome, this condition occurs when the thin layer of cartilage that lines the spinal joints begins to wear away. This can cause the joints to painfully grind against one another, leading to pain and inflammation. The body often produces osteophytes (bone spurs) in an attempt to stabilize the arthritic joint and prevent it from uncomfortably articulating. However, osteophytes can sometimes cause more harm than good, especially when they extend into the spinal canal.

Symptoms of Spinal Stenosis in the Neck

Interestingly, the mere narrowing of the cervical spine does not necessarily cause patients to experience any symptoms. Rather, pain and discomfort occur only when a nearby nerve root, spinal nerve, or even the spinal cord becomes compressed. Neural compression can cause symptoms of pain, numbness, tingling, and/or muscle weakness. In the case of spinal stenosis in the neck, these symptoms can be experienced in the neck, upper back, shoulders, arms, and/or hands.

Treating the Condition Conservatively

Initially, treatment for spinal stenosis aims to make the patient’s symptoms more manageable rather than to open up the narrowed portion of the spinal canal. For most patients, the symptoms of spinal stenosis in the neck can be mitigated through the use of conservative, nonsurgical treatments, such as medication. In fact, many patients are able to find relief by taking medications that are usually already in their medicine cabinets. Nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen and naproxen can help to relieve pain and reduce inflammation by blocking the body’s production of the COX-1 and COX-2 enzymes. Those who aren’t able to take NSAIDs (usually because of a cardiovascular or gastrointestinal condition) can often relieve their pain by taking an analgesic like acetaminophen. If a patient’s pain is severe or debilitating (or if over-the-counter medications prove ineffective), his or her physician may prescribe a narcotic pain reliever or muscle relaxant.

Treating the Condition Conservatively

Many patients also benefit from attending physical therapy sessions. A physical therapist can develop customized strength training exercises that aim to develop the patient’s weakened spinal muscles and ligaments. Building strength can provide the spine with added support and stability, and may also help to relieve some of the pressure that is being placed on the compressed spinal nerve. In addition to strength training, physical therapy can also entail the use of other techniques, including:

• Transcutaneous electrical nerve stimulation (TENS) • Therapeutic ultrasound• Cryotherapy• Thermotherapy• Massage therapy• Posture modification exercises

Surgery for Spinal Stenosis in the Neck

For a small minority of patients with spinal stenosis in the neck, conservative treatments may prove ineffective. If a conservative treatment regimen has failed to relieve the patient’s symptoms after several weeks or months, his or her physician may recommend surgery. Some patients may have the option to undergo an open spine surgery or a minimally invasive alternative. While open spine surgery requires hospitalization and a long and arduous rehabilitation, an endoscopic spine procedure is performed on an outpatient basis and allows many patients to return to their daily activities within a matter of weeks.

Before consenting to any operation, patients should thoroughly evaluate all associated risks. It can prove beneficial to receive a second or third opinion, as another physician may deem surgery unnecessary. In some cases, another physician can determine that the patient was incorrectly diagnosed with spinal stenosis in the neck.

Learning More About Spinal Stenosis

Those who would like to learn more about spinal stenosis in the neck should consult their primary care physician or spine specialist. He or she will be able to provide more information about the condition’s causes, symptoms, and treatments.