Cervical spinal stenosis is narrowing of the spinal canal that usually starts gradually and develops over a long period of time. As the spinal canal narrows, it can squeeze (compress) and irritate the nerve roots that branch out from the spinal cord, or it can squeeze and irritate the spinal cord itself.

 

The goals of treatment for spinal stenosis are to relieve pain, numbness, and weakness in the arms, to make it easier for you to care for yourself (improve function), and to improve your quality of life.

 

Treatment includes pain-relieving medicine, exercises, and other nonsurgical measures, and in some cases, surgical treatment.

 

Initial Treatment:                                                                                                            

Initial treatment usually is aimed at relieving your symptoms without surgery. Most cases do not require surgery. Nonsurgical treatment often works to allow most normal activity and relieve mild to moderate symptoms of pain, numbness, and weakness in the legs.

 

Nonsurgical treatment includes:

• Education about spinal stenosis and the course of your condition and how to relieve your symptoms.

• Medications to relieve pain and inflammation:

  • Acetaminophen

  • Anti-inflammatory medications (NSAID’s)

• Exercise: To maintain overall good health ( a stationary bicycle allows  you to lean forward which can relieve symptoms)

• Weight loss: Loss of weight helps to relieve symptoms and slows the progression of the stenosis.

• Physical therapy: Provides education, instruction and support for your self-care. Helps to relieve your pain and symptoms.

 

Ongoing Treatments:

• Treatments often require nonsurgical treatment on an ongoing basis. Treatments may include:

• Medications to relieve pain and inflammation.

  • Acetaminophen

  • Anti-inflammatory medications (NSAID’s)

• Exercise: To maintain overall good health

• Staying at a healthy body weight

• Physical therapy: Provides education, instruction and support for your self-care. Helps to relieve your pain and symptoms.

 

If these treatments do not relieve your symptoms, your doctor may recommend an epidural steroid injection (ESI), which is used for pain that occurs mostly in the arms.

 

 If your treatments do not improve your pain and symptoms, or if your pain and symptoms get worse, it may mean that your condition is getting worse.  You may

feel:

 

• Numbness

• Weakness

• Have trouble with activities of daily living

• headaches

 

If you have tried nonsurgical treatment for a period of time as determined by your doctor but your symptoms have not improved, surgery may be considered.

• Imaging tests such as MRI or CT scan: To determine the amount and location of narrowing of the spinal canal.

  • Before making a decision about surgery, discuss the severity of your symptoms and the imaging test results with your doctor.

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Surgery may be recommended if you:

• Have severe symptoms of pain, numbness, or weakness in the arms that restricts normal daily activities and quality of life.

• Conservative treatments are unsuccessful.

• Are in otherwise good health and do not have other medical conditions that might make it harder for you to have and recover from surgery.

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For people with severe symptoms, surgery can relieve pain and improve walking ability. But symptoms may return after several years. About 10% to 20% of people who have had surgery need to have surgery again.

 

The main type of surgery for lumbar spinal stenosis is decompressive laminectomy, which relieves the pressure on the spinal cord or the spinal nerve roots.  Laminectomy removes part of the vertebra (bone and/or fibrous tissue) to create space for nerves.

In some cases spinal fusion may be done at the same time to stabilize the spine.