The narrow canal in the neck (cervical spinal stenosis) is defined as the narrowing of the openings called foramen through which the spinal cord or the nerve roots pass through, which are located in the vertebrae. Degenerative changes caused by aging in the spine, deformed large hernias, bone extensions due to calcification, and rheumatic changes may cause narrowing of the canal where the spinal cord is inside. This narrowing may give signs by creating compression on nerve roots or spinal cord.
Stiffness of the neck, pain, difficulty in the use of hands, weakness or numbness in the hands, arms or legs, contractions in the legs, bladder or bowel dysfunction may be seen.
The disease usually begins with numbness and incompetence in the hands accompanying neck pain. The patient’s incompetence increases with time and the skills such as opening the door with the key and button buttoning are impaired. Gait disturbance is added to this complaint over time. If the disease progresses too much, the patient walks with help and by sickling, cannot work with his hands, and urine and fecal control are impaired.
The history of the disease is usually typical. The examination indicates the condition and severity of the disease. Magnetic resonance imaging (MRI), which is one of the modern diagnostic methods nowadays, can easily diagnose the narrow canal in the neck and determine its degree. With MRI, spinal cord damage can be seen as a white spot. SEP (Sensory evoked potential) and MEP (Motor evoked potential) are useful in demonstrating the conduction function of the spinal cord and are required in some cases. Computed tomography (CT) is very good for demonstrating the structure of the neck spine bones. However, the most important criterion in the narrow canal in the neck diagnosis is clinical examination and radiological findings of the physician and their blending.
Possible treatment options
Medical treatment consists of drug use, bed rest, physical therapy and algological approaches. Muscle relaxants, painkillers, and anti-inflammatory drugs are used as drug treatment. In addition, hot or cold application, and the use of neck brace that prevents neck movements have great benefits in the elimination of muscle spasm. In case of illness, physical activities, especially forward and backward bending movements, should be performed slowly and in a controlled manner.
Surgical treatment should be performed when medical treatment does not work or if spinal cord and nerve compression are severe. Surgical treatment can be performed by approaching the anterior or posterior part of the neck. The choice of this is up to the surgeon’s assessment. In kyphotic necks with high anterior pressure, it may be appropriate to approach from the anterior. After removing the neck hernia in necessary levels in here, the spine stems can also be removed. Sometimes lordotic patients with spinal cord and nerve compression from the back can be approached from the back of the neck to relax the spinal cord and nerves. In these surgeries, plate screws and cages can be placed on the spine.