I have spinal stenosis that mostly affects my neck. The doctor says it's just another sign of aging. But what exactly is going on back there? He mentioned degeneration. What's breaking down?
Spinal stenosis is the term used to tell us there is a narrowing of the spinal canal. The spinal canal is a tube-like opening through which the spinal cord goes from the brain down to the bottom of the spine. Usually, there's plenty of room in the spinal canal for the cord.
But many different changes occur in the bony and soft tissue structures of the spine as we age that can contribute to stenosis. Too much narrowing and there can be pressure put on the spinal cord. The result can be neurologic symptoms. With cervical (neck) stenosis, patients report numbness, arm weakness, clumsiness, neck pain, and stiffness.
Most often the changes occur within the spinal canal. The posterior longitudinal ligament located inside the spinal canal can start to thicken. It may even ossify or harden as tiny bits of bone form inside the ligament. If the ossification gets big enough, it can take up extra space in the spinal canal.
Sometimes, bone spurs called osteophytes form. These can occur around the edges of the vertebral bodies, but also around the spinal joints. The presence of these bone growths can alter the biomechanics of the spine (the way the spine moves). Each one of these changes added together can create narrowing of the disc spaces, compression of the vertebral bodies, and ultimately lead to stenosis.
Macondo Mochizuki, MD, et al. Cervical Myelopathy in Patients with Ossification of the Posterior Longitudinal Ligament. In Journal of Neurosurgery: Spine. February 2009. Vol. 10. No. 2. Pp. 122-128.
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