Cervical stenosis is a narrowing of the spinal canal in the neck that can compress the spinal cord and nerve roots. It develops gradually with age and may cause neck pain, arm symptoms, and — when the spinal cord is involved — problems with balance and hand coordination. Treatment ranges from conservative care to decompression surgery depending on severity.
What are the symptoms?
- Neck pain and stiffness
- Pain, numbness, or tingling radiating into the shoulders, arms, or hands
- Weakness or clumsiness in the hands — difficulty with buttons, writing, or fine motor tasks
- Balance problems or an unsteady, broad-based gait (a sign of spinal cord involvement)
- Heaviness or weakness in the legs in more advanced cases
- Bladder urgency or dysfunction in severe cord compression (requires prompt evaluation)
What causes it?
- Cervical spondylosis: Age-related degeneration with bone spur (osteophyte) formation that narrows the canal — the most common cause
- Ligament thickening: The ligamentum flavum thickens and buckles inward with degeneration, reducing canal space
- Disc bulging or herniation: Disc material protruding into the canal contributes to narrowing
- Congenitally narrow canal: Some patients are born with a smaller-than-average cervical canal, making them more susceptible to symptomatic stenosis
- Ossification of the posterior longitudinal ligament (OPLL): Calcification of the ligament behind the vertebrae that narrows the canal
How is it diagnosed?
MRI of the cervical spine is the primary study — it shows the degree of canal narrowing, the level(s) involved, and any signal change within the spinal cord that indicates cord injury. CT scan provides detailed bone anatomy and is essential for surgical planning, particularly when OPLL or bone spurs are involved. A thorough neurological examination distinguishes between nerve root compression (radiculopathy) and spinal cord compression (myelopathy), which guides treatment.
Your Non-Surgical Roadmap — Surgery Is the Last Step
Most patients with this condition get better without surgery. Here's the path Dr. Chavarria follows before an operation is ever on the table:
- 1
Start conservative
Physical therapy, activity changes, anti-inflammatory or nerve medication, and time — the first line for nearly every spine condition.
- 2
Add targeted relief
If symptoms persist, image-guided injections (epidural or nerve blocks) can calm inflammation and pinpoint the source of pain — often avoiding surgery entirely.
- 3
Re-evaluate together
Dr. Chavarria reviews your progress and imaging with you, honestly, and explains exactly where you stand — no pressure, no rush to the OR.
- 4
Surgery — only if it's truly the best option
Reserved for severe or worsening nerve compression, instability, or when conservative care has had a fair chance. When it is right, you'll understand why and what to expect.
Treatment Options in Reno, NV — Conservative Care First
Mild cervical stenosis causing primarily neck and arm symptoms is often managed conservatively with physical therapy, anti-inflammatory medications, and cervical epidural steroid injections. When stenosis compresses the spinal cord and causes myelopathy — balance problems, hand clumsiness, or weakness — surgical decompression is recommended to halt progression and allow recovery. Dr. Chavarria tailors the approach to the patient's anatomy: ACDF or cervical disc replacement for focal anterior compression, and posterior cervical laminoplasty or laminectomy with fusion for multilevel stenosis.
Treatment Procedures
ACDF (Anterior Cervical Discectomy & Fusion)
Anterior Cervical Discectomy and Fusion (ACDF) is one of the most commonly performed and consistently successful spine surgeries. Through a small incision in the front of the neck, the damaged cervical disc is removed, the nerve is decompressed, and the vertebrae are fused — eliminating the source of neck and arm pain.
Learn More →Cervical Disc Replacement (Arthroplasty)
Cervical disc replacement (cervical arthroplasty) removes a diseased cervical disc and replaces it with an FDA-approved artificial disc implant — preserving the natural motion of that spinal segment rather than fusing the vertebrae together. For the right candidate, this motion-preserving approach may reduce stress on adjacent levels over time.
Learn More →Posterior Cervical Fusion
Posterior cervical fusion approaches the cervical spine from the back of the neck to decompress the spinal cord and stabilize multiple vertebral levels with screws and rods. It is used for conditions where the anterior approach is not sufficient — including multilevel cervical stenosis with myelopathy, cervical instability, deformity, and cases where posterior bone anatomy needs to be directly addressed.
Learn More →Cervical Laminoplasty
Cervical laminoplasty is a motion-sparing procedure that relieves pressure on the spinal cord by reshaping and repositioning the vertebral bone (laminae) to expand the spinal canal — without fusing the vertebrae together. It is an excellent option for patients with multilevel cervical myelopathy who want to preserve neck motion and avoid a fusion.
Learn More →