From the Guidelines
Treatments for cervical spinal stenosis and disc osteophyte complex are primarily focused on relieving compression on the spinal cord and nerves.
Diagnostic Imaging
- CT Cervical Spine is more reliable in identifying OPLL and evaluating sequelae related to its diagnosis, as well as assessing neuroforaminal and spinal canal narrowing 1.
- MRI Cervical Spine is useful in assessing cord abutment/signal changes secondary to spinal canal narrowing and evaluating exiting nerve roots in the setting of radiculopathy, although its sensitivity in detecting OPLL is limited 1.
Treatment Options
- Percutaneous interventions, such as cervical facet joint or medial branch blocks, may be considered in some cases, although their use as a first-line test is not well established 1.
- Surgical intervention may be necessary in severe cases of cervical spinal stenosis and disc osteophyte complex to relieve compression on the spinal cord and nerves.
- Conservative management, including physical therapy and pain management, may also be considered for patients with mild to moderate symptoms.
Important Considerations
- The choice of treatment depends on the severity of symptoms, the extent of spinal cord and nerve compression, and the patient's overall health status.
- A thorough evaluation, including diagnostic imaging and clinical assessment, is necessary to determine the best course of treatment for each individual patient 1.
From the Research
Treatments for Cervical Spinal Stenosis and Disc Osteophyte Complex
- Surgical treatment options are available for cervical spinal stenosis and disc osteophyte complex, including anterior cervical discectomy and fusion (ACDF) 2, 3
- ACDF can relieve symptoms, but may also lead to the formation of new osteophytes, which can cause further compression of the spinal cord 2
- Cervical open-door laminoplasty can be used to decompress the spinal cord and relieve symptoms 2
- Surgical treatment of symptomatic anterior cervical osteophytes can include anterior osteophyte resection, with or without instrumented anterior fusion 4
- Artificial cervical disc replacement can be used to treat symptomatic degenerative cervical radiculopathy, and has been shown to improve functional impairment, pain severity, and quality of life 5
- Fully-endoscopic anterior cervical approach can be used for transcorporeal decompression to treat cervical spondylotic myelopathy, without the complications associated with ACDF 6
Surgical Procedures
- Anterior cervical discectomy and fusion (ACDF) 2, 3
- Cervical open-door laminoplasty 2
- Anterior osteophyte resection 4
- Instrumented anterior fusion 4
- Artificial cervical disc replacement 5
- Fully-endoscopic anterior cervical approach for transcorporeal decompression 6
Outcome Measures
- Functional impairment can be evaluated using the Neck Disability Index (NDI) 5
- Pain severity can be evaluated using a standard 11-point numeric scale 5
- Quality of life can be evaluated using the SF-36 Health Survey 5
- Clinical outcome evaluations can include Visual Analog Scale (VAS) scores and Japanese Orthopedic Association (JOA) scores 6