Cervical spinal stenosis
Narrowing of the cervical spinal canal can result in myelopathy that will result in upper motor neuron signs, such as hyperreflexia, especially in the lower extremities. Patient may experience walking difficulties or ataxia. Neck pain is common. Narrowing of the neural foramina in the cervical spine will often cause a radiculopathy. Compression of the cervical nerve roots can result in lower motor neuron signs in the upper extremities, which may result in muscle atrophy and fasciculations. Symptoms typically worsen with extension of the spine and improve with flexion.
Spinal stenosis can be congenital, but more typically it is acquired. It most frequently presents in the sixth decade of life or later due to degenerative changes to the spine that result in progressive narrowing of the spinal canal and/or neural foramina. It is also possible that people with congenitally narrow spinal canals are more likely to experience symptoms during the process of aging. Other risk factors for the development of spinal stenosis include inflammatory arthropathies such as rheumatoid arthritis, traumatic injuries, and neoplastic disease.
Related topic: Lumbar spinal stenosis
M48.02 – Spinal stenosis, cervical region
83561009 – Spinal stenosis in cervical region
Differential Diagnosis & Pitfalls
- Amyotrophic lateral sclerosis – Presents with weakness, and generally lacks sensory symptoms.
- Multifocal motor neuropathy – Presents with weakness, and generally lacks sensory symptoms, and affects distal arms.
- Epidural abscess – Often seen with systemic infection and immunocompromised state.
- Epidural hematoma – Seen in the setting of trauma.
- Spinal dural vascular malformations
- Intramedullary or extramedullary tumors