What it is
Cervical spinal stenosis is a narrowing of the spinal canal in the neck, which can compress the spinal cord (cervical myelopathy) or the nerve roots exiting the cervical spine.
Symptoms
- Neck stiffness
- Hand clumsiness or difficulty with fine motor tasks
- Balance or gait difficulty in more advanced cases
- Arm pain, numbness or weakness if a nerve root is also involved
Causes
- Degenerative disc bulging and facet joint enlargement
- Thickening of the ligamentum flavum
- Congenitally narrow cervical canal
Diagnosis
A neurological examination assessing gait, reflexes and hand coordination, combined with MRI, establishes the diagnosis and severity of cord or nerve-root compression.
MRI findings
MRI shows narrowing of the cervical canal with cord compression and, in some cases, signal change within the spinal cord indicating myelopathy.
Non-surgical treatment
- Activity modification and cervical-focused physiotherapy for mild, non-progressive cases
- Close monitoring for signs of progression
Considering this for your case?
Send your MRI or CT for a specialist opinion before deciding on treatment.
When surgery may be considered
Surgery is generally recommended when there is evidence of spinal cord compression with myelopathic symptoms, since this pattern often progresses without decompression.
Surgical options
- ACDF
- Cervical laminoplasty
- Posterior cervical decompression and fusion in selected cases
Recovery
Recovery timelines vary with the severity of pre-operative myelopathy; many patients see improvement in hand function and gait over months, though the goal of surgery is often to halt progression as much as reverse existing deficits.
Risks
- Incomplete neurological recovery in long-standing cases
- C5 nerve root palsy
- Infection
- Adjacent segment degeneration
Questions to ask your surgeon
- Is surgery necessary now, or can it reasonably wait?
- What non-surgical options are appropriate for my case?
- What are the realistic risks and recovery timeline for me specifically?
Indicative treatment cost
Costs vary by procedure and case complexity. See the spine surgery cost page for indicative planning ranges.
Frequently asked questions
No. Most cases are managed with non-surgical treatment first. Surgery is discussed only when appropriate criteria are met, as outlined above.
A neurological examination assessing gait, reflexes and hand coordination, combined with MRI, establishes the diagnosis and severity of cord or nerve-root compression.
Recent MRI or CT images and reports, a summary of symptoms and duration, and details of any treatment already tried.