Symptoms
The symptoms of spinal stenosis of the cervical spine differ from those of spinal stenosis of the lumbar spine. Typical symptoms are pain in the neck and arms, as well as sensation in the extremities. This can be, for example, a burning or tingling sensation, but also numbness.
The fine motor skills of the hands can be impaired, so that fine motor tasks such as writing can be difficult.Also a gait insecurity, quasi a stumbling over the own feet, can occur with concerning. In the worst case, paraplegia is possible, but this is very rare. The examination and the patient interview (anamnesis) in the case of spinal stenosis of the cervical spine can already provide information about the diagnosis to be made.
The symptoms can be quite typical and thus already indicate a suspicion. If a spinal canal stenosis of the cervical spine is suspected, for example, symptoms such as numbness in the arms, a change in the typeface or other abnormalities are examined. However, further examinations must be performed to clarify other possible diseases.
In the blood test, for example, inflammation values are determined. Without an imaging diagnosis, however, spinal stenosis of the cervical spine cannot be determined with certainty. Certain changes in the spinal column are already visible in X-rays.
X-rays are often used in two planes as an initial diagnosis, whereby they are particularly suitable as a means of clarifying other causes such as tumors or a fracture. The method of choice, however, is magnetic resonance imaging (MRI) of the cervical spine, as ligaments, nerves and intervertebral discs can be assessed particularly well here. A CT examination can also be useful, as bony structures can be assessed particularly well in this case.
It is performed, for example, to plan surgery or to better assess bony processes. Another examination is myelo-CT or myelography, in which a contrast medium is injected into the spinal canal through a puncture needle. Contrast allows a better assessment of constrictions and changes.
This examination is particularly important if the MRI or CT has not provided sufficient information for planning the operation. It is also possible to switch to a myelo-CT if there is a contraindication to an MRI examination. Furthermore, a measurement of so-called sensory or motor evoked potentials can provide indications of spinal canal stenosis.
In this case, responses to a certain stimulus are derived by means of electrodes in the EEG. Thus, for example, muscles or nerves are stimulated. In simple terms, damage to the nerve roots caused by spinal canal stenosis can lead to reduced stimulus responses or a longer time to the stimulus response.
Despite such a finding, imaging is still necessary because the stenosis cannot be proven. With the help of MRI imaging, also known as magnetic resonance imaging, changes in the intervertebral discs, ligaments, spinal cord and nerves or soft tissues can be visualized particularly well. Spinal canal stenosis can thus be particularly well assessed and detected by MRI.
Narrowing of the spinal cord or at the exit points of the nerve roots from the intervertebral holes can be seen. Furthermore, underlying changes in the intervertebral discs, such as a reduction in height, may also be visible. Also abnormalities of the ligamentous apparatus can be assessed well.
This does not mean, however, that every finding in the MRI must also have a consequence. After a certain age, all people show degenerative changes in the spine. Decisive factors are the extent of these changes and the severity of the symptoms of these processes. For a better assessment of the bony conditions in the spine, e.g. during a planned operation, a CT can be helpful, as it allows a better evaluation of the bony structures.
