Cervical Spinal Stenosis: Causes, Symptoms And How To Treat It

Herniated discs can cause back or neck pain, arm or leg discomfort, and even advance into more complicated syndromes such as sciatica, radiculopathy, or myelopathy. We call pain originating in a damaged disc “discogenic” pain.

There are 23 intervertebral discs in the spinal column. These discs are soft tissue joints composed of a hydraulic gelatinous core called the “nucleus pulposus” encased within a firm outer collagen wall termed the “annulus fibrosus.” The discs protect the spinal vertebrae and nerves from sudden impact and absorb shock from spine movements like bending, twisting, and jumping. 

Unfortunately, the disc's outer wall, the annulus fibrosus, can develop traumatic tears (annular tear), allowing the jelly-like nucleus pulposus to push backward out of the tear into the spinal canal or neural foramen. 

The part of the jelly nucleus pulposus that pushes out through the tear is called the herniation. In many cases, this hernia can impinge on a nerve, giving rise to inflammation and irritation of the affected nerve.

Disc inflammation, if left untreated, can lead to degenerative disc disease. The pain in your back from degenerative disc disease comes from irritated (inflamed) nerve fibers within the nearby annular tear.

Degenerative Disc Disease involves various structural, biochemical, nutritional, and molecular changes that occur in the spinal disc over time or following an initial injury to the intervertebral spinal disc in your spine. Degenerative disc disease is a common cause of back pain and neck pain (discogenic pain), sciatica, and radiculopathy. 

Bone spurs, also known as osteophytes, are calcified, hard lumps of additional bone that develop on the ends of spinal bones or surrounding joints. They frequently occur near joints damaged by osteoarthritis, a disorder that causes painful and stiff joints. 

Bone spurs can also form when adjacent cartilage or tendons are inflamed or injured. Osteophytes can sprout from any bone, but they're most common in the neck, shoulders, knees, lower back, fingers, foot, and heels, where cartilage has degraded. Bone spurs are also common around degenerative discs in the spine.

Bone spurs are the body's natural means of redistributing weight over a greater surface, cushioning the bone. They also decrease the range of motion, inhibiting activities that could create bony stress. 

Fortunately, the majority of bone spurs do not create any complications. Patients will only develop symptoms like pain and stiffness if the outgrowths rub against other bones or irritate surrounding nerves.

Disc herniations, cervical degenerative disc degeneration, bone spurs (osteophytes), and thicker ligaments can directly compress the spinal nerve root. Bone spurs commonly form and impinge on the nerve root at the uncovertebral joint on either side of the vertebrae. 

Nerve root compression can be caused by decreased disc space due to the intervertebral disc losing moisture and flattening with age.

Biochemical processes also influence nerve root inflammation and injury. Inflammatory substances from a disc herniation can flow onto the spinal nerve root in the foramen, causing it to become inflamed.

When a cervical spinal nerve is irritated, it can cause neurological impairments in the shoulders, arms, and hands, such as numbness or weakness. Permanent numbness and paralysis might result if the nerve compression and related neurological impairments are not treated.

If cervical stenosis further progresses, the symptoms can get more severe. The following are some severe symptoms of cervical stenosis.

• Incontinence: Bladder and/or bowel control might be difficult to maintain.
• Paralysis: A severe symptom of cervical spinal stenosis can also include paralysis.

If you have mild or intermittent pain due to cervical stenosis, the pain will likely worsen over time if left untreated. The pain will happen more often and at a higher level. There's also the possibility that it'll spread to other parts of the body, making it harder to live with.

The more pain you feel, the fewer activities you can participate in. Movement can exacerbate some individuals' pain, causing them to adopt a sedentary lifestyle. 

People who allow spinal stenosis to go unchecked find it extremely difficult to engage in basic activities such as riding bicycles, swimming, walking their dogs, or going shopping.

Patients can potentially become permanently disabled. This can occur through paralysis or the patient being so weak that they cannot stand and move as normal. Severe cervical spinal stenosis can lead to a person being bound to a wheelchair.

If cervical spinal stenosis is left untreated, it may lead to your nerves becoming damaged, and some of the damaged nerves impacted can be those that control your bladder and bowels. If the damage to these nerves is severe, you could experience incontinence.

The first step is a medical history examination of the patient. The doctor in charge must thoroughly examine the patients' medical records, which should contain extensive information about previous health problems and ailments, drugs, long-term health issues, family history, and past medical treatments.

After the first stage is completed, the doctor looks over the information gathered and reviews it to determine the best approach in order to further the investigation.

The physician conducts a physical examination on the patient, focusing on any abnormalities, instability, or discomfort in the afflicted area. It's also possible that this step needs to include some clinical testing to check the affected body parts' range of motion and reactions.

A physician might be compelled to request a medical imaging test to determine the position and severity of the problem. The most frequent examination in this situation is an MRI scan. Asymptomatic cases can be identified using the scan.

Want a Free MRI Review? At Deuk Spine Institute, the world-class surgeons are standing by to review your MRI and provide you with the best recommendation on getting you out of pain permanently. Request a free MRI review.

Foraminotomy is a fairly-invasive, open-back surgery used to treat the effects of cervical stenosis in the spine that requires the repositioning of tissues and cutting of bone to alleviate pressure on the nerve. 

The recovery time for a traditional foraminotomy is slow and steady, with patients driving a car and performing light physical activities after eight weeks and a full recovery within 18 months.

Frequently performed alongside a Foraminotomy and/or traditional spinal fusion, a laminectomy involves removing parts of the lamina in the spine that may be compressing the spinal cord or spinal nerves. 

Typically involving a large incision and the moving of muscle, skin, and ligaments, Laminectomy surgery enables surgeons to relieve pressure on the spinal cord or nerves by removing the lamina bone or bone spurs. 

The problem with this method is that it causes collateral damage to soft tissues in the area to reach the problematic region.

Deuk Laser Disc Repair is an alternative to dangerous invasive spine surgeries like total disc replacement and spinal fusion. It is the most advanced laser surgery in the world.

This revolutionary procedure was developed by Dr. Ara Deukmedjian MD, a world-renowned neuro-spine surgeon and a true pioneer in minimally invasive, laser, and endoscopic back and neck pain treatment.  

Deuk Laser Disc Repair is a form of endoscopic spine surgery performed in a state-of-the-art surgery center under sedation while the patient relaxes. This procedure does not compromise or weaken the health and integrity of the spine.

If you have a herniated or bulging disc or chronic back or neck pain, submit your MRI for a free review. 

To get started, Deuk Laser Disc Repair requires a very small incision, less than a quarter-inch long. A cylindrical rod called a dilator is inserted in the small opening to gently spread the muscle to create a small passage and guide through which the surgery is performed endoscopically. 

The tip of the dilator is advanced into the symptomatic disc through the tear in the annulus where the herniation originates, and a tube called the retractor slides over the dilator and is carefully positioned into the painful disc. The rest of the entire Deuk laser disc repair surgery will occur inside this narrow tube.

To access the spine, an endoscopic camera is inserted into the tubular retractor to allow the surgeon to guide the laser inside each symptomatic disc. This process ensures that bones and surrounding tissues are not damaged, unlike traditional spinal fusion microdiscectomy:

And artificial discs:

The Holmium YAG laser used in the Deuk laser disc repair is manipulated accurately with millimeter precision under endoscopic visualization to remove only painful inflammatory tissue from the back of the disc. 

The laser is precisely used to remove damaged disc material that is causing the pain. This process is called debridement of the annular tear, and Dr. Deukmedjian was the first in the world to use and publish this technique.

Once the laser has removed the inflamed painful part of the annular tear and the herniated nucleus pulposus, the endoscope and tubular retractor are removed, leaving less than one-quarter inch incision in the skin, which can be closed with a single stitch and a band-aid. 

The total time for the Deuk laser disc repair surgery is one hour, and the patient is in recovery for about 45 to 60 minutes before being released to go home. Hospitalization is not needed, and the risks of hospital-based surgery are avoided. 

Also, with the Deuk laser disc repair, there’s no loss of normal movement, and the flexibility of the disc and joint is preserved. With endoscopic Deuk laser disc repair, no fusion, metal implants, or biological material is added to the spine. The procedure is all-natural, allowing your body to heal the herniated or bulging disc itself.

After the surgery, the Deuk laser disc repair patient is back home, enjoying life with a speedy recovery allowing normal activities without pain. Another advantage of Deuk laser disc repair is that no opioids or powerful narcotic painkillers are needed after surgery. 

Open spine surgeries like microdiscectomy, laminectomy, artificial disc replacement and fusion all cause so much internal trauma that patients are in severe pain after surgery and must take painkillers for weeks after their surgery but not with Deuk laser disc repair.