Note: Only an experienced practitioner can make an accurate diagnosis about vertebral disease. The practitioner’s role is to determine the pathological or non-pathological nature of a disc or vertebral abnormality discovered during an imaging test. The practitioner must then specify the risk and potential for progression, which is essential in therapeutic decision-making. Finally, the practitioner’s diagnosis will make it possible to identify among these abnormalities those that are not responsible for symptoms, do not imply risks, and therefore will not require any particular treatment.
Cervical spinal stenosis often combines the symptoms of a compression of the nerve roots that go towards the arms and the symptoms of a compression of the spinal cord. The involvement of the roots is manifested by pain (cervicobrachial neuralgia) that are either dull (pressure or cramp type), or electrical (shock or tingling type), in all or part of the arm (trapezius, shoulder, hand). The involvement of the spinal cord is more serious and can lead to either loss of tone in the legs (responsible for falls) or genuine paralysis. Pain in the neck does not always occur.
Cervical spinal stenosis is very well diagnosed on a CT scan of the cervical spine, but only an MRI will be able to specify the significance of the compression of the spinal cord and whether or not there is a lesion on it (hypersignal). In case of nerve involvement, electromyogram and evoked potential will make it possible to specify the origin of symptoms and the severity of the involvement.
Surgery: In the decision to perform a cervical spinal stenosis surgery, the evaluation of the benefits and risks is paramount. The surgery will be all the more delicate because the first symptoms of paralysis have already appeared. A this stage, there are risks of not operating and letting a permanent lesion occur, and risks of operating on a spinal cord in a state of great fragility. The treatment decision will always be made with the full understanding of the treatment issues by the patient and his/her treating physician. Two examples of cervical spinal stenosis surgery:
- Hernia removal and disc replacement surgery through the front of the neck
- Vertebral laminectomy surgery through the back of the neck
• POST-OPERATIVE RECOMMENDATIONS
At the clinic: Patients generally first get up the second day after the procedure, with a simple neck brace most of the time. In more complex surgeries, a more rigid immobilization of the neck may be necessary. The physical therapist teaches you and supervises the actions you will have to perform throughout your recovery: how to get up, lie down, bend down, pick up objects on the floor, and perform personal hygiene. During your stay at the clinic, you will regain some autonomy for these everyday tasks. The return home is usually done by medical transport service. Prescriptions for changes of dressing, pain medications, and medical leave until the follow-up consultation will be given to you at discharge.
A surgeon from CCV Montpellier is always on call and can be reached 24 hours a day in case of emergency. Click here to contact