Cervical Spinal Stenosis Treatment: Stopping Neck Pain, Numbness, and Weakness

Cervical spinal stenosis is the narrowing of the spinal canal within the cervical spine, or neck. The spinal canal is the protective bony tunnel (stacked vertebrae) that houses the delicate spinal cord and nerve roots that travel from the brain to the rest of the body. When this space narrows, it inevitably pinches or compresses the neural structures, leading to a variety of neurological and pain-related symptoms.

Compression from CSS can affect individual nerve roots (causing cervical radiculopathy) or the spinal cord itself (a more serious condition known as cervical myelopathy). The symptoms are often progressive and can be highly disruptive to daily life. If you are experiencing neck pain and hand numbness, it is critical to seek a diagnosis.

• Chronic neck pain or stiffness: Persistent discomfort in the neck that may worsen with certain movements.
• Radiating pain (cervical radiculopathy): Pain that travels from the neck into the shoulder, arm, or hand.
• Tingling, numbness, or "pins and needles" feeling: A common sign of nerve compression, often felt in the hands and fingers (myelopathy).
• Muscle weakness: A decrease in strength in the arms or legs, leading to difficulty with fine motor skills (e.g., buttoning a shirt, handwriting).
• Balance and gait issues (ataxia): Trouble with coordination or an unsteady way of walking, a critical sign of spinal cord compression.

CSS is primarily an age-related degenerative condition that develops over time due to wear and tear.

• Age-related degeneration: The gradual breakdown of spinal structures is the most frequent cause.
• Bone spurs (osteophytes): Bony projections that form on the edges of the vertebrae, directly encroaching on the spinal canal.
• Bulging or herniated discs: The soft, cushioning discs between vertebrae can push outward, reducing the space for nerves.
• Thickened ligaments: The ligaments that stabilize the spine can harden and enlarge over time, contributing to the narrowing.
• Arthritis: Osteoarthritis in the facet joints of the spine can cause inflammation and bone-related narrowing.

Neck Pain. What Causes It?

Watch this short video to learn more about the different causes of neck pain.

The diagnostic process begins with a thorough physical exam and a review of your medical history. The physician will assess your reflexes, sensation, muscle strength, balance, and coordination to identify any neurological deficits.

Advanced imaging is essential for visualizing the anatomy of the neck and identifying the exact structure causing the compression.

• Magnetic resonance imaging (MRI): The gold standard for diagnosing cervical stenosis. MRI provides detailed images of soft tissues, allowing doctors to clearly visualize disc herniations, thickened ligaments, and the precise extent of compression on the spinal cord and nerve roots.
• Computed tomography (CT) scans: CT scans are particularly useful for visualizing bone structure, making them the best tool for identifying bone spurs (osteophytes) and bone-related narrowing. A CT is often used when an MRI is contraindicated (e.g., due to a pacemaker or specific metallic implants).

The combination of the patient's clinical symptoms and objective findings from imaging studies allows confirmation of the diagnosis. A clear understanding of the structural problem—where the compression is and what is causing it—is crucial, as it is the only way to determine the appropriate and most definitive treatment.

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The primary goal of any surgery for CSS is decompression—creating sufficient space for the pinched nerve roots or spinal cord to relieve pressure and prevent permanent neurological damage.

Traditional cervical spinal fusion is a common procedure for treating stenosis.

• The process: This involves removing the disc material and/or bone spurs causing the compression, and then permanently joining (fusing) two or more vertebrae using bone graft and metal hardware.
• Cons: Traditional fusion is highly invasive, involves a lengthy and painful recovery period, and significantly limits the neck's natural range of motion. A major risk is adjacent segment disease (ASD), where the stress from the fused segments causes the adjacent, unfused vertebrae to degenerate faster.

The most advanced and preferred surgical option for disc-related cervical spinal stenosis is the patented Deuk Laser Disc Repair® (DLDR) procedure. This procedure is the centerpiece of the Deuk Spine Institute’s approach and offers a superior outcome to traditional fusion.

• How it works: The DLDR® procedure is performed through an incision no larger than a pencil eraser. It utilizes an advanced, high-definition endoscopic camera and a precision, FDA-approved laser to safely and meticulously remove the painful disc material, bone spurs, and thickened ligaments that are causing the narrowing and nerve compression.
• Key differentiators:
  • Minimally invasive: No major cutting of muscle, tissue, or healthy bone.
  • Preserves mobility: No fusion is required, meaning the natural structure and flexibility of the spine are maintained.
  • Faster recovery: The procedure is completed as an outpatient surgery, allowing patients to walk out the same day and return to work the next day without the need for post-operative narcotics.
  • Permanent relief: The procedure directly removes the source of the pain, offering a definitive and long-term cure for symptoms caused by disc and bone spur-related stenosis.

Discover DLDR®

This short video describes our innovative minimally invasive procedure.

Both conditions can cause similar symptoms (pain, numbness, tingling in the arms), but they are fundamentally different:

• Cervical spinal stenosis (CSS): This is the narrowing of the spinal canal—the "tunnel" housing the spinal cord and nerve roots. It is typically a gradual, chronic process caused by age-related degeneration, bone spurs (osteophytes), and thickened ligaments. CSS often affects the overall spinal cord (myelopathy) or multiple nerve roots.
• Cervical herniated disc: This occurs when the soft, inner gel-like material of a single disc pushes out through a tear in the outer casing, directly pressing on a nearby nerve root. Herniations can be sudden (from trauma) or gradual, typically causing pain that follows a specific nerve path down one arm (radiculopathy).

Yes, mild cases of CSS are initially treated with conservative, non-surgical methods to manage pain and slow progression. These include physical therapy, medications (NSAIDs), and temporary steroid injections.

However, non-surgical treatments do not fix the structural problem (the narrowing). If symptoms are severe, progressive, or lead to increasing weakness or coordination issues (myelopathy), surgery is necessary to relieve the pressure and prevent permanent nerve damage.

Because CSS is a progressive condition, leaving it untreated carries the risk of the condition worsening and causing irreversible neurological damage. Potential consequences include:

• Worsening neurological deficits: Growing weakness, numbness, and tingling in the arms and hands, making fine motor skills (like buttoning a shirt or writing) increasingly difficult.
• Myelopathy (spinal cord dysfunction): Severe compression can lead to balance issues, an unsteady gait, and difficulty walking.
• Permanent nerve damage: Prolonged pressure on the spinal cord or nerve roots can result in permanent loss of sensation, muscle wasting, and chronic, debilitating pain.
• Loss of bladder/bowel control: In the most severe, advanced cases, it can cause problems with bladder and bowel function.

Deuk Laser Disc Repair® (DLDR) is a highly effective, minimally invasive treatment for many of the underlying causes of cervical spinal stenosis, particularly those involving disc-related compression (e.g., bone spurs, herniated or bulging discs, and disc degeneration).

DLDR® is recognized as a safe and effective alternative to traditional fusion surgery, designed to safely remove the painful tissue and bone spurs that are causing the narrowing, without fusing the vertebrae or cutting large amounts of bone. The specific treatment plan, whether DLDR® or another decompression technique, is always determined after a full review of your diagnostic imaging (MRI/CT).