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Cervical spinal stenosis
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Cervical spinal stenosis

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Contributors: Phillip Mongiovi MD, Richard L. Barbano MD, PhD
Other Resources UpToDate PubMed

Synopsis

Cervical spinal stenosis is the narrowing of the spinal canal in the neck. Asymptomatic spinal stenosis may be discovered incidentally on imaging, but when it causes impingement of the spinal cord or nerve roots, symptoms can include weakness of the extremities, numbness / paresthesias, and neuropathic / radicular pain.

Narrowing of the cervical spinal canal can result in myelopathy that will result in upper motor neuron signs, such as hyperreflexia, especially in the lower extremities. Patient may experience walking difficulties or ataxia. Neck pain is common. Narrowing of the neural foramina in the cervical spine will often cause a radiculopathy. Compression of the cervical nerve roots can result in lower motor neuron signs in the upper extremities, which may result in muscle atrophy and fasciculations. Symptoms typically worsen with extension of the spine and improve with flexion.

Spinal stenosis can be congenital, but more typically it is acquired. It most frequently presents in the sixth decade of life or later due to degenerative changes to the spine that result in progressive narrowing of the spinal canal and/or neural foramina. It is also possible that people with congenitally narrow spinal canals are more likely to experience symptoms during the process of aging. Other risk factors for the development of spinal stenosis include inflammatory arthropathies such as rheumatoid arthritis, traumatic injuries, and neoplastic disease.

Related topic: Lumbar spinal stenosis

Codes

ICD10CM:
M48.02 – Spinal stenosis, cervical region

SNOMEDCT:
83561009 – Spinal stenosis in cervical region

Look For

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Diagnostic Pearls

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Differential Diagnosis & Pitfalls

  • Amyotrophic lateral sclerosis – Presents with weakness, and generally lacks sensory symptoms.
  • Multifocal motor neuropathy – Presents with weakness, and generally lacks sensory symptoms, and affects distal arms.
  • Epidural abscess – Often seen with systemic infection and immunocompromised state.
  • Epidural hematoma – Seen in the setting of trauma.
  • Spinal dural vascular malformations
  • Intramedullary or extramedullary tumors

Best Tests

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Management Pearls

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Therapy

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References

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Last Reviewed: 08/29/2018
Last Updated: 09/12/2018
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Cervical spinal stenosis
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Cervical spinal stenosis : Gait disturbance, Hyperreflexia, Muscle weakness, Neck pain, Numbness, Paresthesias
Imaging Studies image of Cervical spinal stenosis
Axial GRE MRI sequence demonstrates cervical spinal stenosis with severe central canal narrowing secondary to a large posterior disc osteophyte complex which impresses upon the ventral aspect of the thecal sac/spinal cord.
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