The process of developing cervical stenosis is actually quite simple. Arthritis causes our spinal bones and joints to expand. If you’ve ever looked at your grandparents hands and noticed their knuckles are large, that is because their joints are developing bone spurs as part of the process of arthritis. We all have similar joints surrounding the nerves in our spine. As the spinal joints form bone spurs, they grow into the areas that are normally occupied with very important nerves called the spinal cord and spinal nerve roots. The expanding bone spurs push on the nerves resulting in a medical condition called SPINAL STENOSIS.
After the brain, the spinal cord is our most important nerve structure. For all practical purposes, the spinal cord is like a fiber-optic cable that allows the brain to communicate with, and direct the activities of the rest of our body. Damage to the spinal cord can interrupt any and all of our functions below the neck including movement, sensation, breathing, bowel and bladder function, as well as sexual function. Essentially everything we do-other than think- can be affected. That is the reason that spinal cord damage caused by cervical stenosis can be a devastating problem.
There are two very different types of nerve structures that traverse through our neck. The spinal cord that lives well protected within the bones (vertebrae) in our neck, and the spinal nerve roots that branch off of the spinal cord and exit unprotected from the spine. The spinal cord is the large “master cable” controlling our entire body and the nerve roots are much smaller individual nerves that come off of the spinal cord and go to individual muscles and organs in our body. The spinal cord is extremely delicate and easily damaged by direct contact, but like the brain- cannot feel pain. The spinal nerve roots are very resilient to injury and tolerate compression from bone spurs quite well but are very sensitive to pain. For these reasons, cervical stenosis may or may not be painful, depending on whether or not the spinal cord and or nerve roots are compressed by the bone spurs. If the spinal cord is compressed alone, there may be little or no pain and possibly headaches. If the nerve roots are pinched by the stenosis, it is usually quite painful.
When cervical stenosis is associated with pain, it may be in one or many possible locations. These include the base of the head, neck, face, between the shoulder blades, arm or arms, trunk, and even into the legs. Other sensations may include numbness, tingling, change in temperature, burning, and alteration of any sensation. Muscle pain, spasm, and cramping are common symptoms. In more advanced cases, control of movement is affected. This may include weakness, difficulty with balance and or dexterity of the hands. In advanced cases, loss of controlled use of the arms and legs and even quadriplegia can be a result of untreated cervical stenosis.
Because cervical stenosis is most commonly the result of arthritic bone spurs pinching nerves, it is more common with advancing age. Cervical stenosis is the most common treatable cause of unsteady balance in those over the age of sixty. Cervical stenosis can happen at any age. It is potentially more dangerous in younger individuals. This problem should be considered in every patient of any age, having difficulty with balance gait, or, dexterity. Many patients with treatable neurologic dysfunction from cervical stenosis are wrongly diagnosed as having untreatable diseases such as peripheral neuropathy, multiple sclerosis, and even ALS (Lou Gehrig’s Disease) when they have a treatable and curable cause of nerve dysfunction.
When cervical stenosis is identified and diagnosed early, functional loss caused by nerve damage is treatable and recoverable. Undiagnosed, prolonged nerve damage can and will cause permanent disability.
The basic goal of surgery for the treatment and cure of spinal stenosis is to make room for the pinched spinal cord. The traditional process of laminectomy and fusion involves removing the bone pinching the cord. Unfortunately, the bone pieces that are removed are important parts of the structure that holds our head up and allow for normal function, motion, and strength. When these structures are removed they need to be replaced with screws and rods that do not function at all like the parts they replace. Mobility is compromised, function is lost, stress is transferred to other parts of the spine, and the way the neck feels and works after surgery makes many patients unhappy with the long-term results.
The advent of ultrasonic bone cutters has enabled an entirely different technique for the treatment of cervical and lumbar stenosis.
The problems associates with traditional treatments for cervical stenosis cause legitimate fears in patients. With these new ultrasonic techniques, these problems can be avoided and patient fears can be abated.
If you have cervical stenosis or have been told you need neck surgery, you need to look at this.
With innovative ultrasonic technology, Dr. Cantor and Dr. Asghar are able to treat patients safely and with quicker recovery times than ever before, resulting in unprecedented success and minimized risks. Forgoing traditional tools - screws and rods - we now employ advanced technologies utilizing an ultrasonic device with a linear blade that oscillates at a high frequency. The difference is in the Misonix ultrasonic surgical sculpting tool that uses an oscillating, linear blade moving at a high frequency of approximately 22,500 times a second.
Because ultrasonic bone cutters do not spin or have sharp blades, they can work very close to, even in contact with very delicate nerves. Ultrasonic bone cutters use high frequency vibration that will cut through bone but will not damage delicate nearby structures. Due to the bone’s stiffness, the blade’s energy is absorbed, quickly and efficiently chiseling the bone away at rapid speeds, while reducing the chance of damage to surrounding nerve, muscles and important structures of the spine. This allows surgery to be done from the inside out through tiny incisions. Important structures that hold the spine together are not removed.
Because the important structures are not removed, they do not need to be replaced with screws and rods and fusions. Strength, mobility, and function are preserved. Stress to the adjacent joints in the neck is no longer an issue and the need for additional surgery down the road is diminished. Cervical stenosis is resolved and patients are happier with their results. Neither traditional spinal surgery, nor lasers, can achieve anywhere near the level of safety, specificity, sensitivity, and success enabled with ultrasonic technology and accomplished with new ultrasonic techniques. This process redefines minimally invasive cervical stenosis surgery.
The results? 90% less utilization of rods and screws, fewer limitations in post-procedure mobility, increased strength and a dramatically reduced chance of subsequent surgeries. “The goal of minimally invasive operations is always to take safer approaches from the onset to cause as little destruction as possible, preserve their functions and avoid complications for incredibly successful and shorter recoveries” explains Dr. Cantor.