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  • Cervical spinal stenosis
  • Cervical central stenosis
  • Central stenosis
  • Lateral stenosis

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  • 723.0 Spinal stenosis in cervical region
  • 724.0Spinal stenosis other than cervical

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Description

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  • Common, degenerative spinal condition
  • Associated with narrowing of the spinal canal (central stenosis) or foraminal canals (lateral stenosis)
  • Caused by degenerative changes in intervertebral discs and facet joints
  • Can result in spinal cord compression or nerve root compression

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Essentials of Diagnosis

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  • Causes neurogenic claudication, with pain, cramping, and paresthesias in the upper extremity and lower extremity aggravated by cervical extension, relieved by cervical flexion
  • Diagnosis made by clinical examination
  • Differentiation between vascular and neurologic claudication
  • Reproduction of symptoms in specific postures and activities

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General Considerations

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  • Cervical spinal stenosis can result in spinal cord compression and resulting upper motor neuron signs
  • Cervical central stenosis can give both upper and lower extremity symptoms

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Demographics

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  • Prevalence increases with age
  • Primarily occurs after 65 years of age

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Signs and Symptoms

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  • Bilateral leg pain
  • Unilateral or bilateral upper limb pain and myelopathy with cervical stenosis
  • Pain worse with walking, relieved by sitting
  • Can be with or without neck pain
  • Altered sensation, motor control, and reflexes in the distribution of the involved nerve roots

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Functional Implications

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  • Difficulty with walking long distances
  • Difficulty with standing activities
  • Possible bowel or bladder dysfunction with cervical stenosis
  • Difficulty looking up
  • Difficulty reaching overhead, painting overhead

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Possible Contributing Causes

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  • Postural changes
  • Weakness of core musculature

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Differential Diagnosis

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Imaging

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  • MRI helps to visualize compressed or inflamed nerve root in diagnosis
  • X-ray/plain-film radiograph helpful if osteophyte located in intervertebral foramen
  • CT scan to show herniation compressing the spinal canal/nerves

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Diagnostic Procedures

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  • To hospital for imaging
  • To physician if surgical consult if myelopathy suspected
  • To hospital for imaging and medical consult if disease suspected
  • To vascular surgeon if suspected vascular insufficiency

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