What is Cervical Stenosis? | Jeffrey Cantor, MD
Jeffrey Cantor, MD, Board Certified Spine Surgeon・35 minutes read
Cervical stenosis, a common issue in older individuals, can lead to quadriplegia and severe consequences due to spinal cord compression caused by bone growth. Understanding the severity of stenosis, monitoring symptoms, and opting for early surgical intervention when necessary can improve outcomes and reduce the need for additional surgeries in the long run.
Insights
- Cervical stenosis, characterized by a narrowing of the spinal canal due to factors like bone growth, can lead to severe consequences such as quadriplegia in individuals over 65, highlighting the importance of understanding this condition's impact on mobility and dexterity.
- Surgical intervention for cervical stenosis causing cord damage, especially when symptoms like dexterity issues, balance problems, and pain are present, yields better outcomes than non-surgical approaches, emphasizing the critical role of early treatment in reducing risks and improving patient prognosis.
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Recent questions
What is cervical stenosis?
Cervical stenosis is the narrowing of the spinal canal in the neck due to factors like bone growth or cholesterol buildup, potentially leading to severe consequences like quadriplegia.
How is cervical stenosis diagnosed?
Cervical stenosis is diagnosed through MRI scans, which show a pinched spinal cord within the neck's canal, indicating potential issues with mobility and dexterity.
What are the symptoms of cervical stenosis?
Symptoms of cervical stenosis vary, ranging from no symptoms to severe pain, depending on the location of bone growth and nerve root compression, potentially leading to issues like stumbling, falling, and loss of dexterity.
When is surgery recommended for cervical stenosis?
Surgery for cervical stenosis is recommended when symptoms like dexterity issues, balance problems, and pain are present, especially if myelopathy (cord damage) is detected, as surgical intervention yields better outcomes than non-surgical approaches.
How has technology improved cervical stenosis surgeries?
Ultrasonic technology has revolutionized cervical stenosis surgeries by allowing precise nerve decompression without damaging surrounding tissues, reducing the need for fusions and leading to better long-term outcomes with lower chances of additional surgeries.
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Summary
00:00
Cervical Stenosis: Causes, Symptoms, and Implications
- Dr. Jeffrey Cantor from Canter Spine Center discusses cervical stenosis, a common yet poorly understood issue leading to quadriplegia in individuals over 65.
- Stenosis refers to the narrowing of tubes in the body due to cholesterol or bone growth, impacting channels like blood vessels or the spinal canal.
- Cervical stenosis is visualized through MRI scans, showing a pinched spinal cord within the neck's canal, potentially leading to severe consequences.
- The spinal cord, an extension of the brain, is delicate and can be damaged similarly to the brain, affecting functions like walking and dexterity.
- Neuroplasticity allows the brain and spinal cord to adapt to damage, transferring functions to other areas to compensate for lost cells.
- Damage to the spinal cord can go unnoticed until functions are significantly affected, leading to stumbling, falling, and loss of dexterity.
- Symptoms of cervical stenosis vary, from no symptoms to severe pain, depending on the location of bone growth and nerve root compression.
- Arthritis is the primary cause of stenosis, with bone spurs encroaching on the spinal canal, potentially causing nerve damage, pain, or loss of function.
- The severity of stenosis does not always correlate with symptoms, with some individuals living with severe stenosis without issues, while others may face emergency surgery recommendations.
- Understanding cervical stenosis is crucial as it can impact the spinal cord's ability to function, leading to significant mobility and dexterity challenges over time.
16:18
Predicting Stenosis Impact: New Insights Needed
- Stenosis can lead to sudden mobility issues, but predicting who will be affected is challenging due to the inaccuracy of current methods.
- The spinal canal typically measures 12-14mm, with the spinal cord around 8-9mm, and a 10mm space for both.
- Stenosis is defined as a canal diameter of 10mm or less, but it may not always cause problems, especially in patients with normal spine structure.
- A canal measuring 8mm raises concerns, with one in three patients facing issues, particularly those already experiencing symptoms.
- Patients with an 8mm canal and no symptoms are usually monitored, but surgery is recommended if symptoms arise.
- A canal of 6mm or less is considered dangerous, often requiring treatment even in asymptomatic patients.
- Symptoms like dexterity issues, balance problems, and pain indicate a need for surgical intervention, especially if myelopathy is present.
- Surgical treatment for cervical stenosis causing cord damage (myelopathy) yields better outcomes than non-surgical approaches.
- Delaying treatment for cord damage can increase risks, with early intervention offering more favorable results.
- Diffusion imaging, a new technique, provides detailed insights into nerve health, aiding in determining the severity of stenosis and the need for surgery.
32:03
"Ultrasonic Technology Reduces Need for Fusions"
- Post laminectomy kyphosis occurs due to the removal of the nuchal ligament during a laminectomy procedure, causing the head to fall forward.
- Surgeons have developed fusion techniques to rebuild the structure that supports the head, using bones, plates, and screws to stabilize the spine.
- Fusions, while effective at treating stenosis, lead to increased stress on adjacent joints, potentially causing arthritis and necessitating further surgeries.
- Ultrasonic technology has revolutionized spinal surgeries by allowing precise nerve decompression without damaging surrounding tissues, preserving ligaments and reducing the need for fusions.
- Ultrasonic tools are safer around delicate structures, enabling surgeons to work through smaller incisions and avoid damaging normal tissues.
- By preserving ligaments and using ultrasonics, surgeries can reshape bones from the inside out, reducing the need for screws, rods, and fusions, leading to better long-term outcomes and lower chances of additional surgeries.
