This syndrome is the equivalent of lumbar spinal stenosis occurring in the cervical spine. (See Lumbar Spinal Stenosis). Radiculopathy refers to a dysfunction of a nerve root usually due to a mechanical compression. In this context it is usually due to a herniated disc or bone spur. Myelopathy refers to compression of the spinal cord. The patient may present with neck or radicular pain, but all too often there is a "puzzling" painless development of increased difficulty walking and loss of dexterity in the fingers. This often presents as the inability to button one's shirt or difficulty writing and is sometimes dismissed by both the patient and physician until the disability is significant. Difficulties with balance are one of the earliest signs and should alert patients to the possibility of this condition. The symptoms result from the compression of the spinal cord by overgrown bone and ligaments similar to that of the lumbar spine. This is, however, much more serious because long standing, unrelieved pressure will result in irreversible damage to the spinal cord and permanent disability.
The diagnostic tests and principles of surgery are the same as in lumbar stenosis and the results are generally very satisfactory. (See Lumbar Spinal Stenosis.) The procedure is performed through an incision in the back of the neck and consists of removal of the laminae and ligaments using high speed drills and other instruments. Patients require about four days of hospitalization following surgery. A cervical collar may be worn by patients for comfort, but is not required. The need for further rehabilitative treatment and return to normal activities or work is determined by the degree of preoperative deficit and disability and varies significantly from patient to patient.
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Division of Neurosurgery
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Spine Surgery
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