Cervical stenosis is narrowing of the spinal canal in the neck. This matters a great deal because, in the neck, the narrowing can squeeze the spinal cord itself — not just individual nerve roots. When the cord is compressed and starts to work poorly, it's called cervical myelopathy. This is one of the most important spine conditions to recognize, because if left untreated the nerve damage can become permanent.
Symptoms (often come on slowly)
- Clumsiness of the hands — trouble with buttons, zippers, handwriting, or small objects.
- Balance and walking problems — feeling unsteady, or walking "like on a boat."
- Numbness or tingling in the hands or arms; weakness in the arms or legs.
- Neck pain or stiffness (though sometimes surprisingly little), and in advanced cases, bladder problems.
How it's diagnosed
A careful exam for signs of cord involvement (overactive reflexes, a positive "Hoffmann's sign," an unsteady walk), with MRI of the neck as the key test.
Treatment
For mild myelopathy, close monitoring with therapy and activity changes may be reasonable — but non-surgical care doesn't fix the narrowing, and patients must be watched carefully. (Aggressive neck manipulation and traction can be risky here and are generally avoided.) Surgery is the main treatment for moderate-to-severe or worsening myelopathy, aimed at taking pressure off the cord to stop progression and give the best chance of improvement. Because the damage can become permanent, timely treatment matters.
You have rapidly worsening hand clumsiness, balance, or weakness; a fall; or new bladder problems. Any sudden severe weakness after neck trauma is an emergency.