Neck (Cervical)
Cervical Spinal Stenosis
경추 척추관 협착증
Narrowing of the spinal canal compressing the spinal cord and nerve roots
- How common
- Common in the elderly
- Typical age
- Ages 50–70
What is it?
Multifactorial narrowing of the spinal canal simultaneously compresses the spinal cord and nerve roots.
Commonly affected: Multilevel stenosis at C3–4 through C5–6 is common.
How it develops
- Accumulated degenerative changeOsteophytes, ligamentum flavum hypertrophy, and disc bulging act together.
- Canal narrowingThe normal canal diameter (≥17 mm) narrows to under 10 mm.
- Neural ischemiaNeural blood-flow demand rises during walking but supply is insufficient.
- Neurogenic claudicationLower-limb symptoms appear after a set walking distance and improve with rest.
Symptoms
- Neurogenic claudicationLegs feel heavy with walking and improve with rest (similar to lumbar stenosis).
- Limb numbness / painNumbness or pain may involve both arms and legs.
- WeaknessLimb weakness with gait instability.
- Neck painChronic neck pain.
- Bladder dysfunctionMay be accompanied by urinary incontinence or frequency.
How it is examined
- Limb weakness / sensory lossMixed signs from multilevel involvement.
- HyperreflexiaPositive upper motor neuron signs.
- Abnormal gait testingUnsteady gait; tandem walking impaired.
Imaging
X-ray is used to assess degenerative change and canal diameter.
- Multilevel osteophytes
- Multilevel disc-space narrowing
- Reduced cervical canal diameter
MRI most accurately shows the degree of canal stenosis and cord compression.
- Multilevel cord compression
- Possible intramedullary T2 hyperintensity
- Ligamentum flavum hypertrophy
- Hourglass-shaped cord compression
Non-surgical care
- Mild cases: observationIf symptoms are mild, physical therapy and activity modification.
- BracingCervical collar to limit excessive extension.
Conservative options are generally tried first. Medications listed here can have side effects — discuss them with your prescriber.
When surgery is considered
Myelopathic symptoms, progressive neurologic deficit, or failed conservative care.
Procedures that may be discussed
- Laminoplasty — the most common procedure
- Anterior multilevel decompression and fusion
- Artificial disc replacement
Outlook
60–80% improve after surgery. Earlier surgery yields better long-term outcomes.