Etiology
Narrowing of the spinal canal. As the spine changes with age, bone spurs and arthritis can narrow the spinal canal; known as spinal stenosis. These bone spurs and other tissue can press on the spinal cord and nerve roots affecting the normal nerve function.
Diagnosis
- X-rays, CT scans and MRIs, with contrast dye to make any structural issues more visible
- A physical exam to ascertain which movements cause discomfort
- Nerve function tests
Symptoms
- Loss of balance with poor coordination
- Decreased dexterity
- Weakness and numbness
- Severe cases paralysis
- Pain is a symptom in many patients but may be absent which often leads to a delay in diagnosis
Cervical lesions C3 - C6: loss of manual dexterity with difficulties in writing and nonspecific alteration in arm weakness and sensation.
Cervical lesions C6 - C8: lead to a syndrome of spasticity and loss of proprioception in the legs. Gait disturbance and suffer multiple falls.
Treatment
- Conservative management
- Regular analgesia
- Soft collars to aid patients where instability is the major cause of symptoms
- Physiotherapy involving traction, heat and ultrasound therapy
- Surgical management
- Restore the previous diameter of the spinal canal and thus relieve the compression
- Surgery can be divided into two anatomical areas: the upper C0-C2 and the lower C3-C7 and in two approaches: anterior and posterior