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Cervical Stenosis: Definition, Causes, Risk factors and Complications

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Cervical Stenosis: Definition

What is Cervical Stenosis?

Cervical Stenosis is a disorder in which the spinal canal in the neck area narrows. With less room in the spinal canal, the spinal cord may be compressed or pinched. Some people are born with this condition, but in most cases, it occurs due to the normal "wear and tear" of aging. Cervical Stenosis is most common in people over the age of 50.

Many people with Cervical Stenosis have suffered some type of trauma or injury to their neck, but their injury may have occurred months or years before they begin to develop symptoms of Cervical Stenosis.

Reasons

To understand what happens in Cervical Stenosis of the spine, it's necessary to understand the process of disc degeneration. This is a "wear and tear" process. To help you get a better idea of what happens in your spine, think about two vanilla wafers with a marshmallow between them. The wafers represent two vertebrae and the marshmallow represents an intervertebral disc. If you squeeze the wafers, the marshmallow has some "give" because it's fresh and pliable. It's soft like a pillow. If you leave the marshmallow out on the counter for a week, it will dry out. If you put it between the wafers after it has dried out, it isn't soft and won't provide the cushion for the wafers like it did when it was fresh. It may even split or tear. If you left the marshmallow out for a year, it would be so shriveled and dry, it wouldn't be any good as a "shock absorber" at all. This is similar to what can happen in Cervical Stenosis.

As the body ages, and Cervical Stenosis occurs, the intervertebral discs lose some of their water content. This means they become dehydrated and lose some of their ability to act as shock absorbers and tears may occur in the outer ring of the discs. These tears in the outer ring may not cause any symptoms, so the person may not be aware an injury leading to Cervical Stenosis has occurred. These tears heal by laying down scar tissue which is not as strong as normal disc tissue. As more tears occur, more scar tissue is laid down. More wear and tear injuries keep occurring as time goes on. As the disc ages, it becomes less of a cushion and eventually cannot function as an effective shock absorber.

Eventually, the disc starts to collapse and the space between the vertebrae shrinks. When the disc collapses, this also impacts the way the vertebrae line up with each other. When the bones don't line up like they are meant to, there is less room in the spinal canal which leads to Cervical Stenosis and abnormal pressure is placed on joint surfaces, on the articular cartilage. The articular cartilage is the smooth covering over the end of bones where they come together in a joint. As time goes by, the abnormal pressure causes inflammation and arthritis to develop in the joints. Arthritis also leads to Cervical Stenosis.

Bone spurs may also start to form around the joints and the disc. It could be that too much movement in part of the spine could cause the formation of bone spurs. Eventually, bone spurs may form around the spinal nerves and Cervical Stenosis is the result.

Prevalence

Many people with Cervical Stenosis even though it may be severe, do not know they have the condition. It is apparent on x-ray findings in 5% of all adults. Cervical Stenosis occurs in 7% of people who are at least 50 years old and in 9% of adults over the age of 70 years.

Cervical Stenosis is usually caused by age-related changes in the size and shape of the spinal canal. Everyone experiences some degeneration with aging. People aged 50 years or older are at an increased risk for developing degenerative arthritic changes. As a person ages, the vertebral disc loses some of its water content and, as a result, loses some of its shock absorbing ability. As the disc continues to wear down, it begins to collapse, making the space between each vertebra smaller. The collapse also affects the way that the facet joints (the joints at the back of the spine) line up. Over time, this wear and tear damage from Osteoarthritis of the spinal bones can prompt the formation of bone spurs. As the bone spurs form, the size of the spinal canal becomes smaller and soon may begin to press on the spinal cord or its nerve roots.

Risk Factors

Certain factors increase the risk of developing Cervical Stenosis. They include:

  • Being born with a spinal canal that is more narrow than normal
  • Being female increases the risk of Cervical Stenosis
  • Being older than 50 years
  • Having a history of a spinal injury or spinal surgery
  • Having a history of Osteoarthritis or bone spurs can increase the risk of Cervical Stenosis
  • Having a medical history of inflammatory spondyloarthritis (for example Ankylosing Spondylitis)
  • Having a history of spinal tumors can increase the risk of Cervical Stenosis
  • Having a history of Paget's disease

Complications

If Cervical Stenosis is left untreated, or on rare occasions, treated too late, the patient may have the following complications:

  • Paralysis
  • Permanent Weakness
  • Permanent Numbness
  • Balancing problems
  • Incontinence

All of these complications that may arise from untreated Cervical Stenosis can really be a burden to the patient. If symptoms of Cervical Stenosis are detected or diagnosed, treatment should be done immediately to prevent the aforementioned complications to occur.

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