From the Research
Respiratory Issues in Mild Cervical Stenosis
- Mild cervical stenosis can cause respiratory issues due to the compression of the spinal cord and the involvement of the phrenic nerve, which controls the diaphragm 1, 2.
- Studies have shown that patients with cervical spinal stenosis (CSS) have lower pulmonary function test values, including forced vital capacity (FVC), forced expiratory volume (FEV), and maximal voluntary ventilation (MVV), compared to healthy controls 1, 3.
- The compression of the spinal cord can lead to subclinical pulmonary dysfunction, and FEV% is the most sensitive parameter in detecting these disorders 1.
- Respiratory symptoms such as shortness of breath and dyspnea can be presenting symptoms of cervical spondylotic myelopathy (CSM) and can be related to unilateral diaphragm paralysis caused by CSM 2.
- Surgical decompression can lead to improvements in respiratory parameters, but the evidence is inconsistent and further research is needed to characterise respiratory dysfunction in patients with degenerative cervical myelopathy (DCM) 3.
Mechanisms of Respiratory Dysfunction
- The disruption to cervical nerve roots responsible for diaphragmatic innervation and damage to descending spinal projections from brainstem respiratory centres may contribute to respiratory dysfunction in patients with DCM 3.
- The compression of the spinal cord can lead to neurologic deficits, including respiratory dysfunction, and the size of the spinal canal is a factor that contributes to these deficits 4.
Clinical Implications
- Clinicians should consider cervical spinal stenosis as a potential cause of respiratory symptoms, especially in patients with degenerative cervical myelopathy or cervical spondylotic myelopathy 2, 3.
- Further research is needed to investigate the relationship between cervical spinal stenosis and respiratory dysfunction, and to characterise the mechanisms of respiratory dysfunction in patients with DCM 3.