From the Research
Surgical intervention, specifically anterior cervical discectomy and fusion (ACDF) or cervical laminoplasty, is recommended for patients with moderate to severe cervical stenosis who have persistent neurological deficits, progressive symptoms, or have failed conservative treatment after 6-12 weeks. Treatment options for moderate to severe cervical stenosis include both conservative and surgical approaches. Conservative management typically begins with physical therapy focusing on neck strengthening and range of motion exercises, oral medications such as NSAIDs (ibuprofen 400-800mg three times daily or naproxen 500mg twice daily), muscle relaxants (cyclobenzaprine 5-10mg three times daily), and neuropathic pain medications (gabapentin 300-1200mg three times daily or pregabalin 75-300mg twice daily) 1. Epidural steroid injections may provide temporary relief for radicular symptoms.
Surgical options include:
- Anterior cervical discectomy and fusion (ACDF)
- Cervical laminectomy with or without fusion
- Cervical laminoplasty, such as the double-door laminoplasty technique, which creates an opening in the midline of the spinous processes and a symmetrical expansion with hinges on both laminae 2 The choice of surgical approach depends on the location and extent of stenosis, presence of instability, and patient-specific factors. Surgery aims to decompress the spinal cord and nerve roots while maintaining or restoring spinal stability. Post-surgical rehabilitation is essential for optimal outcomes and typically begins 4-6 weeks after surgery with gradual return to normal activities over 3-6 months. According to the most recent study, surgical treatment can lead to an improvement of the neurological symptoms, and the primary aim of surgical treatment is to avoid deterioration of the neurological deficits 1.