Cervical Spinal Stenosis
Spinal canal narrowing in the neck that can compress the spinal cord
Cervical spinal stenosis is a narrowing of the spinal canal in the neck (cervical spine). When this narrowing compresses the spinal cord itself — a condition called cervical myelopathy — it can cause serious symptoms affecting balance, hand coordination, and even bowel or bladder function. When only nerve roots are affected, the result is cervical radiculopathy (arm pain and numbness). Early diagnosis and specialist evaluation are important.
Symptoms
- Neck pain and stiffness
- Pain, numbness, or tingling radiating into the shoulder, arm, or hand
- Hand weakness or clumsiness (difficulty with buttons, writing, or gripping)
- Problems with balance or gait — feeling unsteady while walking
- Heavy or weak feeling in the legs
- Electric shock sensation down the back with neck flexion (Lhermitte's sign)
- Bladder urgency or difficulty (in myelopathy cases)
Causes & Risk Factors
- Degenerative disc disease and bone spur formation narrowing the cervical canal
- Herniated cervical discs compressing the cord or nerve roots
- Thickening of the posterior longitudinal ligament (OPLL)
- Congenitally narrow spinal canal (increases vulnerability)
- Rheumatoid arthritis affecting cervical joints
- Neck trauma or prior surgery
Treatment Options
Conservative (Non-Surgical)
- Physical therapy with careful cervical stabilization exercises
- Anti-inflammatory medications and muscle relaxants
- Cervical epidural steroid injections for radiculopathy
- Soft cervical collar for short-term symptom relief
- Activity modification to avoid neck hyperextension
Surgical Options
- Anterior cervical discectomy and fusion (ACDF) — the most common approach
- Cervical disc arthroplasty (disc replacement) — motion-preserving alternative to ACDF
- Posterior cervical laminectomy and fusion — for multi-level disease
- Cervical laminoplasty — expands the canal while preserving motion
When to see a spine specialist
Cervical myelopathy (spinal cord compression) requires prompt specialist evaluation. If you have hand clumsiness, balance problems, or weakness in the legs alongside neck symptoms, see a spine specialist or neurosurgeon urgently.
Frequently Asked Questions
How do doctors diagnose cervical stenosis?
Diagnosis begins with a physical exam assessing reflexes, strength, and coordination. An MRI of the cervical spine is the gold standard for visualizing cord or nerve compression. A CT myelogram may be used in patients who cannot have MRI (e.g., pacemaker). Nerve conduction studies can help differentiate nerve root from spinal cord involvement.
What is cervical myelopathy and why is it serious?
Cervical myelopathy occurs when the spinal cord is compressed by narrowing in the neck. Unlike nerve root compression, which is painful but usually reversible, spinal cord compression can cause permanent neurological damage if untreated. Symptoms include hand clumsiness, balance problems, and leg weakness. Early surgical decompression typically stops progression and can allow partial recovery.
Is ACDF surgery safe?
ACDF is one of the most commonly performed spine procedures and has a well-established safety profile. Major complication rates are low (1–2%). The procedure typically takes 1–2 hours and most patients go home the same day or after one night. Most people return to desk work within 2–3 weeks and physical jobs within 6–12 weeks.
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Search spine specialists →Related Procedures
ACDF (Anterior Cervical Discectomy and Fusion)
Fusion surgery to relieve neck pain and arm symptoms from cervical disc disease
Disc Replacement (Arthroplasty)
Motion-preserving alternative to spinal fusion for selected disc disease patients
Laminoplasty
Motion-preserving surgery that expands the cervical spinal canal without fusion
Related Conditions
Medical disclaimer: This content is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare provider for diagnosis and treatment decisions. Last reviewed March 2026. ICD-10: M48.02.