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| Home > Spinal Disorders > Degenerative Spine > Cervical Stenosis - Disorder Treatment |
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CERVICAL STENOSIS
Disorder Treatment
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Non-surgical Treatment
Neck pain due to a degenerative disc disorder is usually treated non-operatively. Everybody will eventually develop some degenerative disc disease, some more than others. Most degenerated discs are not symptomatic. The reason that surgery is usually not necessary for neck pain due to degenerative disc disease is that the degeneration process is known to result in gradual stabilization and even auto-fusion/stabilization of the disc.
While the first line of treatment is almost always non-surgical, the exception is when there is bladder or bowel incontinence or progressive weakness. A vast majority of patients suffering from neck and arm pain will naturally recover given time and non-operative treatment. Non-operative treatments include strengthening exercises, physical therapy, chiropractic, acupuncture, traction, epidural injections, pain medications, and anti-inflammatory medications including steroids.
For arm pain and mild weakness (radicular symptoms), generally at least 6 weeks of non-operative treatment is pursued to monitor for natural recovery. The waiting period is based on the knowledge that 80-90% of radicular symptoms are known to spontaneously recover. If recovery is progressing, more non-operative treatment may be prescribed.
Surgical Treatment
Surgical treatment may be suggested to treat pain that has not responded to non-operative treatment or if there is severe neurologic deficit such as bowel or bladder incontinence or progressive weakness in vital muscle groups. With the exception of the presence of severe neurologic deficits, the decision to proceed with surgery is a quality of life decision.
Surgical options for a cervical spinal stenosis are listed below. These surgical options often include a combination of surgical treatments (i.e. decompression, fusion, instrumentation). For a detailed explanation of the individual treatments, please visit the Surgical Treatments section of the web site.
- Anterior Cervical Decompression and Fusion with Instrumentation
The procedure involves removal of the disc including its compression on the nerves or spinal cord. The resulting void is filled with bone (either from the patient or a bone bank) to fuse the motion segment. The motion segment is held together with instrumentation (plate and screws).
- Anterior Cervical Corpectomy with Fusion
It is often necessary to remove the vertebral body to remove the pressure on the spinal cord. The resulting void needs to be filled with bony fusion, and this is most often stabilized with instrumentation.
- Combined Anterior and Posterior Cervical
Decompression and Fusion with Instrumentation
Sometimes it is necessary to decompress or stabilize the spine both anteriorly and posteriorly.
- Posterior Cervical Foraminotomy
With this procedure, the compression on the nerve is removed from the back of the neck. This procedure is not indicated if the spinal cord is being compressed.
- Posterior Cervical Laminaplasty
The compression on the spinal cord is removed by reconstruction of the lamina.
- Anterior Cervical Decompression and Fusion without Instrumentation
For one level fusion, the fusion rates are high without instrumentation, and therefore some surgeons prefer not to use the plate and screws.
- Posterior Cervical Laminectomy
The compression on the spinal cord is relieved by removal of the lamina.
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