Cervical Spinal Canal Stenosis Surgical Treatment

Spinal canal can be narrower than normal because of  congenital or, more commonly, acquired. The anteroposterior diameter of the spinal canal is 17 ± 5 mm between the 3-7 vertebrae of the cervical spine. For most people, the stenosis results from changes because of arthritis. The spinal canal may narrow. The open spaces between the vertebrae may start to get smaller. The tightness can pinch the spinal cord or the nerves around it, causing pain, tingling, or numbness in your legs, arms, or torso. Neck spinal canal stenosis is seen in the neck vertebrae between 3 and 7 and most often in 5/6 and 6/7 moving regions and may occur in a single range or in multiple levels. Spinal cord and nerve compression may be in the spine in stand position or may increase with neck movements. Myelopathy describes any neurologic symptoms related to the spinal cord and is a serious condition. It can cause permanent spinal cord injury .The process of cellular damage called myelopathy begins in the spinal cord. Myelopathy occurs from spinal stenosis that causes pressure on the spinal cord. If untreated, this can lead to significant and permanent nerve damage including paralysis and death. Several diagnostic tests can be used including standard x-rays and other imaging such as an MRI or CT scan and neuropsychological tests. The treatment plan of this disease should be different for each patient. Mild cases can be treated conservatively. All surgery shares the goal of relieving pressure on the spinal cord. There are several surgical procedures used to treat cervical spinal stenosis that is causing cervical myelopathy such as;

1. From the front of the neck(anterior approach): Discectomy, Discectomy + Instrumentation + Fusion, Removal of the vertebral body, Corpectomy + Cage insertion + Instrumentation + Fusion
2. From back of the neck(posterior approach): Laminectomy, Laminectomy + Instrumentation + Fusion, Laminoplasty

The operations can be performed single level or more than two levels. During the operation, Intraoperative neurophysiological monitoring is used to avoid neurological deterioration. Therefore, it is one of the critical part of spine-spinal cord surgery.