What is Cervical Foraminal Stenosis?
Each neck vertebra or bone in the cervical spinal column has a foramen or tunnel on each side of it through which nerve roots exit the spinal column. Cervical foraminal stenosis, then, refers to the constriction or narrowing of a foramina. When a foramina becomes too narrow, it can put pressure on the nerve root, causing neck pain and other symptoms.
Narrowing of a cervical foramen is most commonly caused by degenerative changes or “wear and tear” associated with aging. As a person ages, bone spurs can form where a nerve root exits the cervical foramen, thus compressing the nerve as it passes through. This narrowing of the foramen can also be caused by a herniated or bulging disc that decreases the size of the passageway, squeezing the nerve roots in the process. Certain congenital problems may predispose a person to cervical foraminal stenosis.
Cervical foraminal stenosis typically causes neck pain that radiates into the shoulders and arms. It can also cause numbness, tingling, and weakness in the arms or hands due to pressure on the nerve roots. Narrowing of the cervical foramen usually occurs on only one side of a vertebra, which in turn can lead to symptoms in only one shoulder or arm. Less commonly, stenosis involving the foramina on both sides of the vertebra can cause symptoms on both sides of the body.
The neck pain and stiffness of cervical foraminal stenosis usually develops slowly over many years and may appear intermittently. It can be made worse by participating in certain activities or when holding the neck in certain positions. Some people live with this condition for years, attributing it to a “strained neck.” When the narrowing progresses and puts excessive pressure on the nerve roots, other symptoms such as of numbness, tingling, and weakness may develop.
A physical exam is always the first step in the diagnosis of cervical foraminal stenosis. Examination of the neck plus a neurological exam can be used to pinpoint which nerve roots are being compressed. X-rays are often performed to identify problems such as bone spurs that may be compressing the cervical foramen. This is typically followed by an MRI study of the neck. If the MRI does not identify the problem, a CT scan combined with a myelogram may be necessary.
Anti-inflammatory medications and physical therapy or cervical traction may offer some relief, especially when the symptoms are mild. A nerve root block may be helpful in more advanced cases. This involves injecting a numbing medication and steroid into the area of nerve where it leaves the spinal column. An epidural injection of steroid medication into the area that surrounds the spinal cord may also temporarily relieve the symptoms. When symptoms fail to improve with conservative measures, surgery may be an option. A variety of surgical approaches may be considered, each with the goal of making more room for the nerve root to pass through the narrowed foramen. Fortunately, most people respond well to surgery for cervical foraminal stenosis.
Dr. Tom Wascher will review your imaging studies free of charge or, if needed, provide you with a second opinion. He has performed over 1,800 cervical surgeries during his career and wants to see that you receive the best treatment possible. He is a competent and caring surgeon who has your best interests in mind.