CONDITIONS

What is it?

Cervical stenosis is the narrowing of the spinal canal. Spinal canal is the space occupied by the nerves and the spinal cord.  

What causes it?

Cervical stenosis is most commonly caused by a bulging or herniated disc which protrudes into the spinal canal instead of staying between the vertebrae where it belongs.  It is also be caused by overgrowth of arthritic tissues. On rare occasions, stenosis could occur due to a tumor, bleeding, or severe trauma to the neck. 

What happens?

When the space gets narrow, the cervical nerve roots and/or the spinal cord get compressed. This affects how they function and causes various symptoms.  These can include pain in the neck and shooting or aching pain in the arms, and numbness or tingling.  The final and most severe symptoms of nerve compression are muscle weakness and possible muscle wasting.  

What are the treatment options?

There are many treatment options for cervical stenosis.  The one that would be recommended for you depends on many factors including the severity or duration of symptoms and what type of treatments have already been done in the past. The treatments may include physical therapy, medications, injections, and surgery.

What is it?

Cervical radiculopathy is the irritation of cervical nerve roots. 

What causes it?

Cervical radiculopathy is usually caused by compression from cervical stenosis (see description for cervical stenosis).  

What happens?

The most common symptom of cervical radiculopathy is shooting pain into one or both arms.  Other symptoms include numbness, tingling, and muscle weakness.

What are the treatment options?

There are many treatment options for cervical stenosis.  The one that would be recommended for you depends on many factors including the severity or duration of symptoms and what type of treatments have already been done in the past. The treatments may include physical therapy, medications, injections, and surgery.

What is it?

The vertebrae in the spine are connected by discs.  These discs provide the spine with flexibility.  A spinal disc is not a uniform structure.  It has a tough outer covering and a soft inner portion.  The outer covering holds the vertebral bones together and contains the soft inner portion. The soft inner portion serves as a cushion.  

Disc herniation is the protrusion of the soft portion of the disc through the outer covering into the spinal canal (like jelly out a doughnut).

What causes it?

The disc can herniate because of severe trauma, recurrent injury, or degeneration (wear and tear) that slowly weakens the outer portion.

What happens?

When the disc herniates out (like jelly out of a donut) it can compress the nerves and the spinal cord.  If the disc tissue gets close enough to the nerves, it can chemically irritate them even if they are not physically compressed.  Spinal nerve root compression or irritation can cause significant symptoms including arm pain, numbness, and weakness.  If the spinal cord itself is compressed, it can lead to a more serious condition called cervical myelopathy (see description).  

What are the treatment options?

There are many treatment options for cervical stenosis.  The one that would be recommended for you depends on many factors including the severity or duration of symptoms and what type of treatments have already been done in the past. The treatments may include physical therapy, medications, injections, and surgery.

What is it?

The vertebra in your spine are connected by discs in the front and small facet joints in the back.  Because the spine moves, the discs and the joints eventually start wearing out.  The process of “wear and tear” (degenerative osteoarthritis) of the disc and facet joints in the spine is called Spondylosis.

What causes it?

Cervical spondylosis is caused by normal wear and tear. Degeneration may start earlier than expected if a patient smokes, is subjected to trauma to the facet joints or if history of spine degeneration runs in their family. Additionally, certain diseases and medications can cause early degeneration.

What happens?

As the joints degenerate, the spine may become less flexible and any motion of the spine may cause pain.  An arthritic spine is also more prone to injury.  A patient with already degenerative spine will have more pain with sprain or strain and the symptoms will last longer.  As with any other arthritic joints, spondylosis may cause overgrowth of bone spurs and arthritic soft tissue.  Such bone spurs can compress the nerves causing cervical radiculopathy (see description).  

Patients with cervical spondylosis typically experience neck stiffness and pain when moving the neck up and down and side to side.  

What are the treatment options?

There are many treatment options for cervical stenosis.  The one that would be recommended for you depends on many factors including the severity or duration of symptoms and what type of treatments have already been done in the past. The treatments may include physical therapy, medications, injections, and surgery.

What is it?

The vertebrae in your spine are connected by discs in the front and small facet joints in the back.  Because the spine moves, the discs and the joints eventually start wearing out. The process of “wear and tear” (degenerative osteoarthritis) of the disc is called Degenerative Disc Disease.

What causes it?

Cervical Degenerative Disc Disease is caused by normal wear and tear. The degeneration may start earlier than expected if a patient smokes, if their discs are subjected to trauma, or if there is a history of spine degeneration in their family. Certain diseases and medications can also cause early disc degeneration.

What happens?

As the discs degenerate, they first lose water content, becoming stiffer.  Next the discs lose their height and the vertebral bones get closer together.  Clinically, the spine may become less flexible and motion may cause pain.  An arthritic spine is also more prone to injury.  A patient who already has degenerative spine will have more pain with sprain or strain and the symptoms will last longer.  As with any other arthritic joints, disc degeneration may cause overgrowth of bone spurs, which in-turn can compress nerves causing cervical radiculopathy (see description).  

Patients with cervical degenerative disc disease typically experience neck stiffness and pain when moving the neck up and down and side to side.

What are the treatment options?

There are many treatment options for cervical stenosis.  The one that would be recommended for you depends on many factors including the severity or duration of symptoms and what type of treatments have already been done in the past. The treatments may include physical therapy, medications, injections, and surgery.

What is it?

Spondylolisthesis means excessive back and forth motion (slippage) of one vertebra over another.  It can cause significant neck pain, as well as clicking and grinding sensations. 

What causes it?

Spondylolisthesis is typically caused by wear and tear of the facet joints that connect vertebrae in the back of the spine.

What happens?

The facet joints (together with the disc) hold the vertebrae together to create the spinal column.  These joints should allow the vertebrae to flex and extend but prevent them from shifting back and forth.  Chronic wear and tear can cause arthritis in these joints.  As a result of the arthritis and chronic inflammation, the facet joint can become loose and allow for more shifting back and forth motion of the vertebrae.  This motion can cause pain in the neck and can pinch nerves causing arm pain, weakness, and numbness. 

What are the treatment options?

Treatment for spondylolisthesis typically begins with physical therapy and anti-inflammatory medications.  Steroid injections and radiofrequency ablation can be done to manage the pain.  Ultimately, surgery may be needed to fuse the vertebrae together and stop the abnormal motion and pain.

What is it?

Cervical myelopathy is a serious condition. It usually happens when there is a severe compression of the spinal cord. The spinal cord originates from the brain stem and is the “main cable” connecting the brain to the rest of the body. 

What causes it?

Anything that severely compresses the spinal cord can cause cervical myelopathy. The most common reason is a large cervical disc herniation (see description). Other causes include large bone spurs due to arthritis, severe trauma to the neck, infection, bleeding, or tumor.

What happens?

If the spinal cord gets compressed hard enough, it will cause a disruption in signal transmission. This can result in arm and leg pain, weakness, and numbness.  It typically causes problems with balance and muscle coordination, including fine finger control needed for proper handwriting, typing, buttoning buttons, etc.  In severe cases, cervical myelopathy can cause bowel and bladder control problems (retention or incontinence).

What are the treatment options?

The spinal cord is extremely delicate and sensitive to pressure.  Once it is compressed hard enough to cause symptoms, the problem typically will not go away without surgery.  

Surgery needs to be done as soon as possible to get the pressure off the spinal cord. The longer it is delayed, the higher the risk of permanent neurologic damage and/or disability.