CERVICAL STENOSIS

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Cervical Narrow Canal

Each of the seven vertebrae contains a canal through which the spinal cord passes. As part of the normal aging process, the discs lose some of their water content over time and begin to overflow. However, in some patients, the protrusion of the disc and other arthritic changes between the vertebrae narrow the space through which the spinal cord and branches of the spinal cord, called nerve roots, pass.

degeneration of the discs and joints between the vertebrae causes compression of the nerve roots. This is called the cervical narrow canal. " Stenosis " means narrowing, " cervical Stenosis is the narrowing of the space in which the spinal cord and nerve branches pass, which occurs in the neck region.

The spinal cord transmits signals from the brain to our arms, legs and trunk. It also carries signals from our arms, legs, and torso back to the brain. Spinal nerve roots are responsible for controlling individual muscles or feeling certain areas of structures such as arms and legs.

The cervical spine is the part of the spine that is inside our neck. This part of the spine should be flexible enough to move our neck from right to left, top to bottom. This part should also be strong enough to protect the delicate spinal cord and spinal nerves that run through it.

The cervical spine consists of 7 vertebrae and cushions (discs) and connective tissue between these bones.

cervical Myelopathy and Cervical What is Radiculopathy ?

cervical Myelopathy refers to loss of function in the upper and lower extremities (limbs) that develops as a result of compression of the spinal cord in the neck region . cervical Radiculopathy is the loss of function in a specific region of the upper extremity as a result of irritation or compression of the spinal nerve root in the neck .

Symptoms

cervical What Are the Symptoms of Myelopathy ?

In many patients, cervical myelopathy progressively progresses over time. May cause slight changes in the way your hands work. Patients may notice that their dexterity is reduced, they drop items more frequently, they cannot fasten their shirt buttons as easily as they used to, or their writing is worse than before. Loss of balance may occur and may create the need to hold on to things while walking. There may also be noticeable imbalances in gait. In extreme cases, severe weakness and numbness in the arms and legs may occur. Rarely, there may be changes in bowel or bladder control.

cervical What Are the Symptoms of Radiculopathy ?

cervical Radiculopathy manifests as pain that starts in the neck and radiates to a specific area of the right or left arm, forearm, or hand. In many cases, these complaints are accompanied by weakness of certain muscles of the arm, forearm, and hand in the same location.

cervical Myelopathy and Cervical What is the Natural Course of Radiculopathy ?

cervical The natural course of radiculopathy largely depends on how long the person has had complaints . The prognosis is generally very good in patients presenting with very early symptoms. In most of these patients, pain, numbness and weakness completely disappear within a period of 6-12 weeks. The outcome is more uncertain in patients whose symptoms have been present for a longer period of time.

In some patients, pain can be completely relieved with limited treatments such as changing activities, heat, ice applications, physical therapy, or over-the-counter medications. In approximately one-third of these patients, symptoms persist at a rate that the patient can cope with. In a small group of patients , the complaints are intolerable and further treatment may be required in these individuals.

clinically evident cervical Although the "natural course" is more uncertain in myelopathy , there is consensus that the symptoms will progress over time in patients with myelopathy . However, it is not known when, how much and how fast the symptoms will progress. A progressive deterioration is observed in approximately 75% of patients, with periods of improvement between periods of deterioration. A slow but continuous worsening occurs in 20 percent, while a rapid deterioration is observed in 5%.

Diagnostic Methods

cervical Myelopathy and Cervical How is Radiculopathy Diagnosed?

If the complaints in your arms or legs worsen and your family doctor thinks that it is caused by the neck vertebrae, you should consult a spine surgeon. If you still have numbness or weakness in one of your arms after a short observation period, you should definitely go to a spine surgeon.

Your spine surgeon will first ask how your complaints started and how they progressed. He or she will then ask a few questions specifically about your neck, and then do a physical examination of the function of your neck, as well as the nerves in your arms and legs. Your spine surgeon will check your balance and evaluate your gait. Your doctor may order an X-ray from you. In some patients , findings of disc spaces or degenerative changes in facet joints can be seen in these films. X-rays taken by bending the neck may show a slight shift between the cervical vertebrae.

Magnetic resonance imaging (MRI) may also be ordered. MRI enables the visualization of tissues with the possibility of compression on the spinal cord or nerve roots. In some patients, an examination may be required by injecting dye into the spinal cord ( myelogram ), after which CT (Computerized Tomography) is performed. In some patients, electrical examination of the spinal cord and nerves may be performed with electrodiagnostic tests.

Electromyogram (EMG) and nerve conduction studies cervical It helps to distinguish between radiculopathy (a condition related to neck roots) and other nerve diseases in the arm and forearm, such as carpal tunnel. Somatic sensory evoked potentials (SSEP) are electrical tests that examine signal transmission within the spinal cord . It can be done in some patients with myelopathy .

Treatment Methods

cervical Myelopathy and Cervical What is the Treatment Process in Radiculopathy ?

cervical Most patients with radiculopathy are initially treated with non-surgical methods. These methods typically involve altering activities for a short period of time.

Activity changes include simple measures like changing the height of your computer or the height of your office chair. Your doctor may recommend applying ice or heat to the painful area. He or she may also recommend over-the-counter pain relievers. However, it should be kept in mind that every drug can have a side effect if used excessively. Prolonged bed rest is generally not recommended as it can cause deconditioning .

the use of stronger prescription drugs such as anti- inflammatory drugs, muscle relaxants or narcotic pain relievers may be required for a short time.

Physical therapy is an important part of the rehabilitation process. In physical therapy, your body functions will be evaluated and you will be informed about correct ergonomics, and a light program for stretching and flexibility will be started.

Light strengthening exercises are included in the program as your pain subsides . An important benefit of gaining conditioning with physical therapy is to prevent the development of secondary stiffness, which can often occur in the shoulders, elbows, neck and arms in patients with pain and loss of strength.

cervical root disease, the spine surgeon may recommend injection therapy. Epidural is the most common of these. steroid are injections . These are cortisone injections made around the irritated nerve in your neck area . The purpose of the injection is to reduce inflammation and relieve pain due to nerve compression .

In patients with mild neck stenosis whose spinal cord is not significantly affected, non-surgical treatment may be an option. This treatment usually begins with patients being thoroughly informed about their condition. Patients should understand that the narrowing of the channels in the spine will one day predispose to spinal cord problem ( myelopathy ). Patients should be careful to avoid situations or injuries that put their spinal cord at risk. A short-term restriction of movement in a soft collar may be beneficial in some patients.

can provide information on correct walking mechanics and practices such as the use of a cane or walker that can prevent falls . Occupational therapists can also offer advice on activities of daily living such as bathing, dressing, opening jars or using keys.

Among the causes that trigger the development of progressive nerve damage (myelopathy) in patients with narrowing of the spinal cord space, there are wearing out with age, injury to the already compressed spinal cord by a fall or traffic accident, abnormal movement in the spine or a combination of all these . cervical myelopathy If their complaints are prominent or progressive, you should be evaluated by a spine surgeon.

cervical What are the Surgical Methods for Stenosis , Myelopathy and Radiculopathy ?

In patients for whom non-surgical measures have failed, surgical treatment is a viable option. Your spine surgeon may recommend an operation from the front ( anterior ), back ( posterior ) of the neck , or both. To determine the type of surgery to be performed, your surgeon will first examine some factors. These include pinpointing the points of compression in the spinal cord or nerve roots, the level of compression, the alignment of your neck spine, and your general medical condition.

If the surgery will be performed on the front of your neck, a small incision will be made on the front of the neck. The tissues are gently taken to the sides and the neck vertebrae are easily reached. Tissues pressing on the nerve root are removed. Often, some bone from the bone bank or from your hip is placed between both vertebrae and both vertebrae are fixed together with the help of a metal plate and screws.

Anterior surgery can be done at multiple levels and may also require removal of discs and vertebrae. The resulting cavity was restored with a bone-filled titanium cage and fixed with a plate from the front. Depending on the surgery, you may need to wear a neck brace for a short time after the surgery.

When surgery is performed on the back of the neck , the incision is made just above the point where the nerves exit the spinal cord. Bone protrusions pressing on the nerve can be removed with a high-speed milling cutter. Small disc particles can be removed from this hole. You may need to rest for a while after the surgery.

posterior surgery, there may be two operations in which the entire spinal cord is released ( decompression ): laminectomy and laminoplasty . In both surgeries, the back parts of the vertebrae are removed and the pressure on the spinal cord is relieved. In laminectomy, the back of the spine is completely removed. In laminoplasty , a hinge is created on the back of the vertebra and the lamina is lifted over this hinge to make room for the spinal cord. Sometimes metal screws or plates are used to stabilize the spinal column in the neck area.