The cervical spine contains the spinal cord and the nerve roots that travel into the shoulders, arms, and hands. These structures pass through limited spaces within the spinal canal and neural foramina.
Please review the Cervical spine anatomy section for more information.
Cervical spinal canal and nerve compression disorders occur when these spaces become narrowed or when a disc, bone spur, ligament, cyst, tumor, or other abnormal structure presses on the spinal cord or a cervical nerve root.
Some compression disorders cause neck pain alone. Others may produce arm pain, numbness, weakness, loss of coordination, balance difficulty, or progressive neurological problems.
Major Diagnosis Types
Below are the major types we see in our clinic. Click on available links to learn about our approach to the problems.
Cervical Spinal Stenosis
Cervical spinal stenosis is narrowing of the central spinal canal.
The spinal canal is the passageway that contains the spinal cord. As this space becomes smaller, the spinal cord may become compressed.
Common causes include:
- Degenerative disc disease
- Disc bulges or herniations
- Bone spurs
- Facet joint enlargement
- Thickening or calcification of spinal ligaments
- Cervical instability
- Congenitally narrow spinal canal
- Tumors or other masses
Mild stenosis may cause no symptoms. More advanced stenosis may lead to cervical myelopathy.
Minor Diagnosis Types
These terms are often encountered, but are either less often treated or described within one of the above diagnoses.
Cervical Foraminal Stenosis
Cervical foraminal stenosis is narrowing of the neural foramen, the opening through which a cervical nerve root exits the spine.
This narrowing may result from:
- Loss of disc height
- Disc herniation
- Bone spurs
- Facet arthritis
- Uncovertebral joint enlargement
- Spondylolisthesis
- Foraminal cysts or masses
When the narrowing irritates or compresses a nerve root, patients may develop pain, numbness, tingling, or weakness in the shoulder, arm, or hand.
The pattern of symptoms often depends on which cervical nerve root is affected.
Cervical Lateral Recess Stenosis
The lateral recess is the area along the side of the spinal canal near the entrance to the neural foramen.
Narrowing in this region may affect a nerve root before it exits the spine.
Lateral recess stenosis may result from:
- Disc protrusion
- Bone spur formation
- Facet hypertrophy
- Thickened ligaments
- Degenerative changes involving several structures
This condition may contribute to cervical radiculopathy and often occurs together with central canal or foraminal stenosis.
Cervical Nerve Root Compression
Cervical nerve root compression occurs when one of the nerves leaving the cervical spine is irritated or physically compressed.
Common causes include:
- Cervical disc herniation
- Foraminal stenosis
- Bone spurs
- Facet cysts
- Fractures
- Tumors
- Infection
- Postoperative scar tissue or structural changes
Symptoms may include:
- Sharp, burning, or electric arm pain
- Numbness or tingling
- Muscle weakness
- Reduced reflexes
- Pain worsened by certain neck positions
Symptoms usually affect one side, although compression may occasionally occur on both sides.
Cervical Spinal Cord Compression
Spinal cord compression occurs when the space available for the cervical spinal cord becomes reduced.
Potential causes include:
- Severe cervical spinal stenosis
- Large disc herniation
- Bone spurs
- Ossification of the posterior longitudinal ligament
- Ligament thickening
- Tumors
- Epidural abscess
- Hematoma
- Fracture or dislocation
- Cervical deformity
Spinal cord compression does not always produce immediate symptoms. However, persistent or progressive compression may damage the spinal cord and lead to cervical myelopathy.
Cervical Radiculopathy
Cervical radiculopathy is a group of symptoms caused by irritation or compression of a cervical nerve root.
It is not a single structural diagnosis. Instead, it describes the clinical effects of nerve root dysfunction.
Symptoms may include:
- Neck and arm pain
- Numbness or tingling
- Shoulder, arm, or hand weakness
- Reduced grip strength
- Reflex changes
Common causes include disc herniation and foraminal stenosis.
The location of symptoms often helps identify the affected nerve root, but individual patterns may vary.
Cervical Myelopathy
Cervical myelopathy is dysfunction of the spinal cord caused by compression, injury, or disease within the cervical spine.
This condition may develop gradually and can be overlooked during its early stages.
Possible symptoms include:
- Hand clumsiness
- Difficulty writing
- Trouble buttoning clothing
- Dropping objects
- Balance difficulty
- Unsteady walking
- Leg stiffness
- Weakness
- Numbness in the hands or arms
- Electric sensations with neck movement
- Bowel or bladder changes in advanced cases
Cervical myelopathy is generally more concerning than isolated nerve root compression because spinal cord dysfunction can become permanent.
Cervical Myeloradiculopathy
Cervical myeloradiculopathy occurs when a patient has symptoms of both spinal cord compression and nerve root compression.
A patient may experience:
- Arm pain or numbness
- Focal arm or hand weakness
- Loss of hand coordination
- Balance difficulty
- Leg stiffness or weakness
- Reflex abnormalities
This combination commonly develops when degenerative changes narrow both the central spinal canal and the neural foramina.
Central Cord Syndrome
Central cord syndrome is an incomplete spinal cord injury that typically affects the arms and hands more severely than the legs.
It most commonly occurs after trauma in a patient with preexisting cervical spinal stenosis. The neck may be forced backward, temporarily narrowing the spinal canal and injuring the central portion of the spinal cord.
Symptoms may include:
- Hand and arm weakness
- Difficulty using the hands
- Numbness or tingling
- Less severe leg weakness
- Balance difficulty
- Bladder dysfunction
The severity varies widely. Some patients recover substantially, while others have persistent neurological deficits.