Stenosis is narrowing of the open spaces in the spine, and this exerts pressure on the spinal cord as well as the nerves which travel through the spine to your arms and legs. Stenosis / narrowing in the neck is known as cervical foraminal stenosis.
Spinal stenosis may produce no signs or symptoms at all in some people, whilst others may complain of discomfort, pain, numbness, tingling, and muscle weakness.
Symptoms of cervical foraminal stenosis
A majority of the people show no clinical manifestations at all. However, when symptoms do appear, they start slowly and aggravate with time.
- Cervical stenosis is seen as tingling numbness, pain and discomfort and weakness in the arm, hand or sometimes in the leg.
- There could be problems with gait and balance.
- Nerves to the bladder or bowel may get affected, causing incontinence.
Causes Of Cervical Foraminal Stenosis
Stenosis may be congenital, i.e. present since birth or may develop due to various factors:
- Bone overgrowth: Damage due to osteoarthritis triggers the bone spur formations, which grow into the spinal canal; this narrows the space significantly.
- Herniated disks: Soft cushions between the spinal vertebrae may herniate. They then press onto the spinal nerves.
- Thickened ligaments: Cords which hold the bones of the spine together may thicken with time. These thickened ligaments protrude into the spinal canal.
- Tumor masses in the space between the spinal cord and vertebrae are a significant cause.
- Trauma to the spine: Injury causes dislocations and / or fractures and this can damage the spinal canal.
Treatment Options For Cervical Foraminal Stenosis
Your doctor will prescribe medicines to manage the pain and discomfort as well as the muscle weakness depending upon the symptoms present.
- Non steroidal anti-inflammatory drugs allay pain and lessen the inflammation appreciably.
- Muscle relaxants: These drugs calm muscle spasms which are frequently seen with spinal narrowing.
- Anti depressants: Tricyclic antidepressants assuage chronic pain.
- Anti seizure drugs: They are prescribed to help decrease pain caused by damaged nerves.
- Drugs that contain codeine-related medicine help deal with excruciating pain; however, they are habit forming.
- Hot or cold packs help relieve discomfort.
- Diet and nutrition: Incorporate these foods – ginger, soy and garlic; they are beneficial for bone and nerve related complaints. Furthermore, losing excess weight will decrease load-bearing stress on the spine.
Physiotherapy: Physiotherapy is a must to manage the symptoms of foramina stenosis, it helps build strength and endurance, enhances flexibility of the spine and improves balance.
Steroids: Injecting corticosteroid into the space around the narrowing reduces the inflammation and relieves some of the pressure on the surrounding structures. However, repeated steroidal injections weaken bones, thus, only a couple of injections are advocated.
Surgery For Cervical Foraminal Stenosis
Surgical intervention becomes necessary if the conservative treatments do not help you. The chief aim is to allay the pressure on the spinal cord and nerves by creating more space within the spinal canal.
- Laminoplasty:Opens up the space in the spinal canal by making a pivot on the lamina. Metal hardware helps bridge the breach in the opened segment of the spine. In this procedure, the lamina of the affected vertebra is removed. It may also be necessary to connect the vertebra to an adjacent vertebra with metal hardware, and a bone graft helps sustain the strength of the spine.
- Laminotomy:A section of the lamina is excised, to help allay pressure in one specific area.