Pain relievers such as paracetamol and codeine may be used. Medications to relieve pain and reduce inflammation are utilised. TREATMENTĬervical spinal stenosis is almost always treated conservatively in the first instance. Shoulder problems may sometimes be confused with pain due to pressure on the nerve roots, and a shoulder ultrasound and/or MRI may be ordered, or an orthopaedic opinion obtained. In some situations, such as when you are unable to have an MRI, you may also undergo a CT myelogram, where a CT scan is performed after contrast dye is injected into the spinal canal. These typically include computed tomography (CT), and magnetic resonance imaging (MRI). To determine the cause of your symptoms, your neurosurgeon or spinal surgeon may require several radiological investigations. The medical term for one such syndrome is ‘central cord syndrome’. However, a sudden or severe force such as a car accident or fall can result in severe symptoms in a patient with pre-existing cervical stenosis. This is because the spinal cord has the capacity to accommodate to some extent. The symptoms of cervical spinal stenosis may be very mild or even absent even when significant stenosis is present. Balance and coordination problems, as well as bowel and bladder incontinence may develop. This is an irreversible weakness and loss of muscle bulk of the muscles of the arms, hands and sometimes legs. Spinal cord compression may result in a myelopathy. Compression of the nerves is generally worse when the patient extends the neck (but is sometimes worse when the chin is placed forwards on the chest), and this usually increases the amount of arm pain. This causes further pressure on and irritation of the nerves. When the intervertebral foraminae (‘neuroforaminae’) are reduced in size due to surrounding build up of tissue, the nerves react to the pressure by swelling. If spinal nerves are being strongly pinched, a radiculopathy may occur and the patient can experience constant arm pain, as well as numbness and weakness. Spinal cord resulting in imbalance and coordination difficulty (myelopathy).Spinal nerves causing arm pain (radiculopathy).Stenosis in the cervical spine can affect both the: SYMPTOMS Symptoms due to compression of the spinal cord and/or nerves include: Unfortunately, these are the spinal cord and nerves. The end result of all of this additional tissue formation is that the softest structures in the spine get squashed. Spondylolisthesis, the slipping forwards of one spinal bone (‘vertebra’) on another, also may occur and lead to compression.Bone spurs (osteophytes) often form, compressing nerves or the spinal cord.The facet joints (the small joints of the spine which hold the vertebral bodies together) and ligaments also thicken and harden to further narrow the spinal canal and intervertebral foramen. As a result, the discs decrease in height and bulge backwards toward the spinal canal and intervertebral foramen.
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