FAQ: NECK SPINAL STENOSIS
What is Neck Spinal Stenosis?
Neck Spinal Stenosis usually appears in relatively young patients (aged 20-60) because of Disc Herniation and in older ages (60 and over) due to degenerative narrowing of the cannal.
Are those degenerating changes preventable?
Unfortunately medicine has not yet found a way to prevent the degeneration process in the human body. We still haven't found procedures or exercises that slow those processes.
What are the classic symptoms of Neck Spinal Stenosis and spinal cord pressure?
There is no definitive symptom that can tell us if there pressure on the spinal cord each of the symptoms below can indicate that there is pressure on the spinal cord and so physical and imaging exams are required.
Neck pains that project to the upper or lower limbs or to both.
Difficulty doing gentle motoric actions with the upper limbs.
A decrease in the rough strength of the lower or upper limbs or both.
A difficulty controlling the sphincters.
In a physical exam we can detect brisk reflexes and pathologic reflexes.
Which imaging exam is the best for early discovery of pressure on the spinal cord?
A neck area spine MRI exam is the best exam to detect pressure on the spinal cord.
Which preventive procedures are recommended?
Unfortunately when there is pressure on the spinal cord with neurological symptoms preventive procedures are almost completely inefficient and only a surgery to reduce the pressure from the spinal cord can efficiently stop further neurological deterioration.
Does Neck Spinal Stenosis necessarily require surgery?
Depends on the amount of pressure, when there is a strong deformation of the spine my advice is to get a surgery because without surgical interference most chances are that irreversible neurological damage will occur. In extreme cases of limb paralysis and loss of control of the sphincters.
Does the surgery improve neurological damage that was already made?
Unfortunately a surgery does not improve existing neurological damage. The surgery prevents further neurological deterioration. Because of that it is important to get the surgery before neurological deterioration occurs.
What are the surgery's success rates?
The surgery's success rates in stopping neurological deterioration are excellent. Unfortunately the surgery does not improve neurology that was already lost.
How long does the surgery take?
One height takes an hour and a half and every additional close height takes about an hour.
How is the surgery performed?
The surgery can be performed in a front or back approach. I refer to the front approach since I find it preferable in most cases (only in cases in which there are multiple heights involved in the narrowing of the cannal a back approach is preferable). I make a 4-5 cm cut on the front of the neck. Through it I reach the disk between the vertebras. Using a microscope designed for surgeries I cut out the disc completly and so remove the pressure from the spinal cord. Instead of the disk I removed I will insert a special cage or an artificial disk.
Who is the surgery for?
To every patient who suffers from spinal cord pressure.
What are the risks of the surgery?
The more pressure there is on the spinal cord the higher the risks become. The risks include amongst others:
Damage to a big blood vessel- less than one percent
Hoarsness after the surgery is caused by the pressure put on the nerv in the larynx. The hoarsness usually passes up to a month after the surgery
Difficulty swallowing- due to pressure on the windpipe- passes a few days after the surgery
Cerebrospinal fluid leak- less than one percent
Irreversible neurological damage- less than one percent
Splinting failure- less than one percent
Lack of fusion- body doesn't creat enough bone matter- few percentages
Infection - less than one percent
Damage to the esophagus- less than one percent
Windpipe damage- less than one percent
How many hospitalization days after the surgery?
Usually hospitalization lasts a day after the surgery.
Is there any need to stay in bed after the surgery?
No, you can start walking immediately after the surgery.
Is there any need for a hard collar?
If the surgery was on a single height there is no need for a hard collar. If the surgery was on two heights or more you will need to wear a type ASPEN hard collar for a month and a half.
What is the size of the surgical scar?
Is there any need for stitch removal?
No. Dissolving stitches.
Can I go back to participate in any activity I want after the healing period?
Yes after the bone was fused you can go back to doing any activity you like.
How long will I be missing from work?
Two weeks to a month and a half.