The spinal canal may be narrower than normal in the neck due to reasons such as congenital, spinal aging, and arthritis. The anteroposterior diameter of the spinal canal in the neck is 17±5 mm between the 3rd and 7th vertebrae of the cervical vertebrae. Over time, the process begins with the degeneration of the intervertebral discs, causing the disc spaces to narrow, the appearance of beak-like bone formations called osteophytes at the ends of the spine, and growths in the joints and connective tissues. If this process narrows the spinal cord and nerve root canal and causes pressure on the nerves, clinical signs and symptoms occur. Cervical spinal canal stenosis is seen in the cervical vertebrae between 3 and 7, and most frequently in mobile areas such as 5/6 and 6/7, and can occur in a single space or in more than one space.
Spinal cord and nerve compression may occur in a stationary spine or may increase with neck movements. A process of cellular damage called myelopathy begins in the spinal cord. In case of harm to the patient, surgery is required. Magnetic resonance imaging, computed tomography, electrophysiological examinations such as sep, mep, emg and normal x-ray of the neck are used in the diagnosis of the disease called cervical spondylotic myelopathy radiculopathy. The treatment plan for this disease should be made differently for each patient. Mild cases can be treated conservatively. The aim of surgical treatment is to relieve the pressure on the spinal cord and nerve roots. When making a surgical treatment plan; Single-multi-level compression-stenosis, front-back compression, neck curvature (lordotic, neutral, kyphotic), excessive-low movement, instability should be taken into consideration.
Surgeries
From the front of the neck: Discectomy, Discectomy + Instrumentation + Fusion, Removal of the vertebral body, Corpectomy + Cage placement + Instrumentation + Fusion
Those performed from the nape of the neck: Laminectomy, Laminectomy + Instrumentation + Fusion, Laminoplasty
They can be listed as follows. Surgeries can be at a single level or at multiple levels. Cervical spinal canal stenosis surgeries aim to open and widen the canals where the canal diameter drops to 5-6 mm. Therefore, it is in the group of critical spine-spinal cord surgeries. An early warning system is used against neurological deterioration during surgery.
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.
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