The Reliability of Ratios of Anatomical Measurements. Determining the Sagittal Dimensions of the Canal of the Cervical Spine. Cervical Spinal Stenosis: Determination with Vertebral Body Ratio Method. Neurapraxia of the Cervical Spinal Cord with Transient Quadriplegia. Posterior approach laminectomy or laminoplastyĬervical spinal canal stenosis can lead to:Įpidural, subdural, or intradural abscessĭiffuse idiopathic skeletal hyperostosis (DISH)ġ. These two tenets are used to guide decision-making in pursuing conservative or operative management.Īnalgesics including acetaminophen and nonsteroidal anti-inflammatory drugsĪnterior approach discectomy or corporectomy The objective of treatment of cervical spinal stenosis is based on two tenets, which are symptom control and further neurological and functional decline. The Muhle staging system utilizes a special device that facilitates T1- and T2-imaging of the cervical spine in positions from 50° of flexion to 30° of extension 7. The Muhle staging system can also be used to grade cervical spinal canal stenosis. On T2-weighted sagittal images, the Kang grading system can be used to classify cervical spinal canal stenosis based on the severity of spinal cord compression 8. The canal-to-body ratio of Torg and Pavlov can be used to determine the presence of cervical canal stenosis 1-3. Posterior longitudinal ligament ossification The etiology of cervical spinal canal stenosis is divided into congenital or acquired etiologies.Īcquired etiologies can be sub-classified into degenerative, systemic, infectious, traumatic, and iatrogenic etiologies and include 9,10: Chronic compression of the spinal cord results in inflammatory changes and edema and manifests clinically as a progressive decline of upper limb neurological function. It can be associated with vascular compression with arterial involvement resulting in ischemia or venous involvement resulting in stasis. Intervertebral disc degeneration causing disc herniation and direct compression of the dural sacįacet joint degeneration causing joint instability and hypertrophy, which worsens the degree of dural sac compressionĬapsule and ligament thickening, and osteophytic and cystic changes further worsen the degree of compressionĬervical radiculopathy is caused by cervical canal stenosis at the level where the nerve roots exit the cervical spine and are commonly in the setting of disc herniation and/or facet joint hypertrophy.Ĭervical myelopathy is caused by cervical canal stenosis leading to direct compression of the spinal cord. Weakness of the proximal lower extremitiesĬervical spinal canal stenosis in the setting of age-related degeneration is caused by 9,10: Progressive loss of fine motor function of the handsĭecreased or absent sensation of the arms or hands Patients with cervical spinal canal stenosis may be asymptomatic or present with neurological symptoms predominantly affecting the upper limbs and include 9: Cervical spinal canal stenosis carries a reported prevalence rate of 1 in 1000 persons over 65 years of age and 5 in 1000 persons over the age of 50 in North America.
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