The lower cervical segments are commonly the level responsible for cervical spondylotic myelopathy; however, we rarely encounter stenosis at the upper cervical segment in a clinical setting. We assumed that there might be some differences between the pathogenetic mechanisms underlying the development of cervical canal stenosis at different segments. We performed positional MRI in the weight-bearing position for consecutive symptomatic patients. All subjects were classified into four groups A: normal; B: C stenosis; C: C stenosis; D: two-level cervical segments stenosis, stenosis at C and C Age, sagittal cervical canal diameter, cervical intervertebral disc degeneration, cervical cord compression, and cervical mobilities were evaluated for each group. Group B showed a narrow cervical spinal canal structure at the C3 to C4 pedicle levels, while groups C and D showed narrow structures at the C4 to C6 pedicle levels in the cervical spine. Additionally, the sagittal cervical canal diameters at all pedicle levels, except C7, in group D were significantly smaller than those observed in group C. We demonstrated the differences in the pathogenetic processes for the development of cervical spinal canal stenosis between C, C, and two-level cervical segments stenosis. Our results suggest that the developmental morphological structure of the cervical spinal canal plays an important role in the development of cervical canal stenosis at different segments. Moreover, individuals with sagittal cervical canal diameters of less than 13 mm may be exposed to an increased risk for future development of cervical spinal canal stenosis at the upper cervical segments following stenosis at the lower cervical segments.
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What is the natural history of these conditions
A common cause of neck pain, especially in older patients, is cervical stenosis. Cervical stenosis is a narrowing of the spinal canal in the neck area or upper part of the spine. This narrowing places pressure on the spinal cord. Many patients with cervical stenosis have a history of some kind of injury or trauma to the neck, however, this trauma may have occurred many months or even years before the onset of stenosis symptoms. Good treatment for cervical spinal stenosis is always based on an accurate diagnosis. The comprehensive diagnostic process includes:. Your doctor will talk to you about your symptoms, how severe they are, and what treatments you have already tried. You will be carefully examined for limitations of movement, problems with balance, and pain. During this exam, the doctor will also look for loss of reflexes in the extremities, muscle weakness, loss of sensation or other signs of spinal cord damage.
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Spinal stenosis occurs when the space within the spinal canal or around the nerve roots becomes narrowed. Spinal stenosis is a narrowing of the spaces within your spine, which can put pressure on the nerves that travel through the spine. Spinal stenosis occurs most often in the lower back and the neck. Some people with spinal stenosis may not have symptoms. Others may experience pain, tingling, numbness and muscle weakness. Symptoms can worsen over time. Spinal stenosis is most commonly caused by wear-and-tear changes in the spine related to osteoarthritis.
If the space within the spinal canal is reduced too much, neurologic deficits can result from spinal cord compression, a condition called myelopathy. See What Is Spinal Stenosis? Conditions resulting from the natural degeneration of the spine can cause the spinal canal to narrow and compress nerve roots. Watch: Cervical Spinal Stenosis Video This condition can result in a variety of serious symptoms anywhere in the body at or beneath the location of spinal cord impingement. Watch: Myelopathy Video.