The cervical spine is the uppermost part of the spine, that is, the neck. This part of the spine must be flexible enough, but also strong enough to protect the spinal cord passing through it and the nerves exiting the spinal cord. The cervical spine consists of 7 vertebrae and the discs and soft tissues between these bones.
The spinal canal passes through the middle of these seven vertebrae, and nerve channels pass through the side canals between the two vertebrae. As people get older, some of the water in the discs is lost over time, the fullness of the disc is lost, the disc height and disc space decrease, the disc expands in its area and puts pressure on the nerves. In advanced cases, these degenerations in the disc combine with arthritic changes (calcifications) and put pressure on the spinal cord passing through the spinal canal and the nerves passing through the side canals. This condition is called cervical spinal stenosis, cervical spinal cord canal stenosis.
Stenosis means narrowing, and cervical spinal stenosis is the narrowing of the canal that occurs in the neck region, through which the spinal cord and nerve branches pass. The disease that develops due to canal stenosis is called cervical myelopathy. Myelopathy does not develop in every blood stenosis.
The spinal cord is like a highway that distributes the signals it receives from the brain to the whole body. In addition, sensations such as pain, touch, hot, cold and deep sensations in the body are transmitted to the brain via the spinal cord.
Cervical myelopathy is a disease that progresses insidiously over time. The first changes usually begin in the hands. Clumsiness, pain, and morning stiffness may occur in the hands. Diabetic neuropathy, MS, ALS, and root compression cause similar symptoms, so great care should be taken when diagnosing. Due to lower extremity involvement, loss of balance may also occur and there may be a need to hold on to objects more than before while walking. Walking may deteriorate over time. Due to loss of deep sensation, patients may lose control of their lower extremities. In very advanced cases, severe weakness and loss of sensation in the arms and legs may occur. Rarely, there may be changes in bowel or bladder control.
Prognosis
Cervical radiculopathy is a difficult disease to treat. The outcomes of patients who are detected early and treated effectively are much better. Appears occasionally after symptoms begin There are periods when rates increase and decrease relatively. In some patients, pain can be eliminated by activity modifications, hot and cold applications, physical therapy, spa treatments or medications. In approximately one-third of these patients, symptoms continue to a level that the patient can cope with. In a small group of patients, the complaints are intolerable and surgical treatment may be required in these people. In a large group of patients, complaints are largely progressive. In a very small group of patients, symptoms progress rapidly and the patient may remain bedridden.
How is the diagnosis made?
Pain in the arms and legs, stiffness in neck movements, Cervical canal stenosis should definitely be considered in patients who have been suffering from neck pain for years, have been treated for these reasons many times, or even have undergone some surgical intervention. Studies such as neck x-rays in flexion and extension, MRI, tomography, EMG, SSEP are generally diagnostic. Diseases such as MS, ALS, diabetic neuropathy, vitamin deficiencies, and syringomyelia should also be taken into consideration when making a diagnosis.
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What is the treatment?
Patients with cervical canal stenosis Most are initially treated with non-surgical methods. These methods include changing activities, ergonomic interventions, avoiding activities that strain the neck, neck muscle strengthening exercises, and paravertebral IMS applications to control symptoms in most patients. Activity changes include simple measures such as changing the height of your computer or the height of your chair at work. Your doctor may recommend applying ice or heat to the painful area. Bracing may be required to rest the neck.
When surgical intervention is required
Compared to other spine diseases, surgical treatment is used as a more common treatment method here, because pressure It is an emergency to relieve the pressure on the spinal cord underneath. It is difficult to predict how quickly things may deteriorate, so surgery should be performed when the decision is made. It may not be possible to reverse the damage that has occurred even after surgery. Even if these patients undergo surgery, there may be some negativities in their quality of life.
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