Surgical and Post‐Operative Management of Cervical Spine Stenosis
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Search Strategy[edit | edit source]
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Definition/Description[edit | edit source]
Narrowing of the spinal canal in the neck. This can lead to squeezing or compressing of the nerve roots where they leave the spinal cord or it can damage the spinal cord itself.[1] These conditions are referred to as radiculopathy and cervical spinal myelopathy respectively.
Epidemiology/Etiology[edit | edit source]
Spinal stenosis occurs most commonly in either the lumbar or cervical regions of the spine. Abnormalities that can lead to stenosis are twice as likely to be seen on an MRI in patients over the age of 40[2]; however, stenosis may present without any signs or symptoms. In fact, degenerative changes that manifest in images or scans of the cervical region have been found to not correlate to neck pain.[3]
There are two main types of spinal stenosis[4]:
- Primary: born with a canal that is narrower than most people. Not very common, but usually leads to spinal stenosis in the middle of life.
- Acquired: usually result of disease or injury to the spine such as the causes listed.
- Age related changes, which include: chronic degeneration, excessive growth of the bones such as osteophytes, destruction of the cartilage, and bulging of the disc.
- Osteoarthritis
- Thickening of ligaments that connect the bones.
- Congenital factors such as Craniodisphyseal Dysplasia3, Achondroplasia, and Paget’s disease of the bone.
- Spinal Tumors
- Spinal injuries causing dislocations or fractures.
Examination/Diagnosis[edit | edit source]
A complete exam including medical history and a neurological screen is essential to determine whether neurological findings exist (either myelopathy or radiculopathy) and whether surgery or other conservative intervention is indicated.[2] Diagnosis of spinal stenosis can only be done with imaging and MRI is the method of choice for diagnosis of spinal stenosis and any possible spinal cord damage.[2]
Medical Management (current best evidence)[edit | edit source]
Physical Therapy Management (current best evidence)[edit | edit source]
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References[edit | edit source]
- ↑ 1.0 1.1 Mayo Clinic Staff. Spinal Stenosis. http://www.mayoclinic.com/health/spinal-stenosis/DS00515/DSECTION=causes. Updated July 8, 2010. Accessed April 12, 2011.
- ↑ 2.0 2.1 2.2 2.3 Meyer F, Borm W, Thome C. Degenerative cervical spinal stenosis: current strategies in diagnosis and treatment. Deutsches Ärzteblatt International [serial online]. May 16, 2008;105(20):366-372. Available from: CINAHL Plus with Full Text, Ipswich, MA. Accessed April 11, 2011.
- ↑ Naique S, Laheri V. Stenosis of the cervical canal in craniodiaphyseal dysplasia. The Journal Of Bone And Joint Surgery. British Volume [serial online]. April 2001;83(3):328-331. Available from: MEDLINE with Full Text, Ipswich, MA. Accessed April 5, 2011.
- ↑ Ullrich PF. Cervical Stenosis with myelopathy. http://www.spine-health.com/conditions/spinal-stenosis/cervical-stenosis-myelopathy. Accessed April 12, 2011.
