Cervical Stenosis: Case Study 124

This 70 year old female has had a five year history of increasing weakness in both her arms and legs. She has lost her balance often, and has difficulties with fine motor dexterity and coordination. Her MRI scan shows marked compression of the spinal cord (Images A & B). Note the hourglass compression of the spinal cord at multiple levels, especially C5-6. The red reveals the dimensions of the spinal canal, the blue the dimensions of a normal spinal canal.

Stenosis CS1 A
Stenosis CS2 B

On the axial MRI images C-E, note the marked compression of the spinal cord especially at C5-6. The space available for the spinal cord has been essentially fully occupied by the disc. Note that even though the spinal canal is patent at C6-7 (Image E), the spinal cord itself is significantly atrophied due to the chronic compression.


Stenosis CS3 C
Stenosis CS4 D
Stenosis CS5 E

A posterior cervical laminaplasty was performed, followed by an anterior C5-6 discectomy and fusion. Note the abundant room for the spinal cord on the postoperative sagittal MRI scan (Image F). Note the axial MRI scans at C4-5 and even at C5-6, which show abundant room for the spinal cord (Images G & H).

Stenosis CS6 F
Stenosis CS7 G
Stenosis CS8 H