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oblems with

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of spinal stenthe bowels a

pinal Steno

Conditions thmn of the nenosis causes and bladder,

osis.

hat narrowck is callmyelopa change

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What par

Spine

The spinebody. A b

my

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eck

f a column oftaches to the

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f bones. Eace back of the

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vertebra, is fody, forming

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round blockk of bone, callled a ver

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bones, attachina bones forer, the bony

vertebral dissorber. It pro

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vertebral dishock. The nuonnective tis

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sc fits betweotects the sppine, such as

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en each vertpine against ts jumping, ru

p of two partd in place byach bones to

ertebral bodyr the back of

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tebral body athe daily pulunning, and

ts. The centey the annuluo other bones

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urrounds and

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er, called theus, a series ofs.

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is formed byh pedicle bothe vertebrae spinal cord

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y two sets of one connectsa bones are std as it passes

ine bones. Tne during act

provides mossurrounding

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st of the ait. Ligam

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Causes

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co d sp d co

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y spinal canaslightly less tdrops to 10 mal cord. The sord as a resul

enosis may d

ongenital steegeneration pinal instabiisc herniatioonstriction o

f Interve

problem?

al normally hthan the size

millimeters, symptoms olt of the pres

develop for a

enosis

lity on of the blood

ertebral

has more thae of a penny.severe sympf myelopath

ssure.

any number

supply to the

Disc

an enough ro. Spinal stenptoms of myehy result from

of reasons.

e spinal cord

oom for the snosis occurs welopathy occm pressure ag

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d

spinal cord. when the cacur. Myelopagainst the sp

e more comm

Typically, thanal narrows athy is a termpinal cord an

mon causes o

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of spinal sten

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Spinal inInstabilithead or nrheumatoshift and

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ople are borns early in lifeup to have pthe canal tenn of bone sp

ration

on the spine ebral disc canal and redund can also p

nstability

nstability canty in the cervneck. Peopleoid arthritis cclose off the

s

n with a spine, but havingpressure againds to becompurs (small b

from aging an begin to cuce the spacepush into the

n cause spinavical spine ca with diseascan cause the spinal cana

nal canal thag a narrow cinst the spin

me narrower bony projecti

and from reollapse, shrie available toe spinal cana

al stenosis. San happen ifes that loosee ligaments al. Whatever

at is narroweanal to beginal cord. Peopdue to the efions) that po

peated stressinking the spo the spinal cal. All of the

Spinal instabf the supporten their connin the upperr the cause, e

er than normn with placeple born witffects of agin

oint into the s

Degeneras and strain pace betweencord. The lig

ese condition

bility means tting ligamennective tissuer bones of thextra movem

al. This is cas them at risth a narrow sng. These despinal canal

tion is the mcan cause mn vertebrae. gaments thatns narrow th

there is extrnts have beenes may also

he neck to looment in the b

alled congensk for stenosspinal canal egenerative cand put pres

most commonmany problem

Bone spurs t hold the vee spinal cana

a movementn stretched ohave spinal osen, allowin

bones of the

nital stenosissis. Even a moften have pchanges oftessure on the

n cause of spms in the cermay form th

ertebrae togeal.

t among the or torn from instability. Fng the topmspine can le

s. They mminor necproblemsen involvspinal co

pinal stenvical spin

hat protruether may

bones ofa severe For examost neck ad to spin

and myel

Disc her

Spinal stedownwarfrom a bldisc. Thiand cause

Neck

Constric

The chanThe sectimyelopat

lopathy.

niation

enosis can ord pressure olow to the hes is called a e symptoms

Herniat

ction of the b

nges that hapions of the spthy.

occur when aof gravity anead or neck, disc herniatof spinal ste

tes

blood suppl

ppen with depinal cord th

a disc in the nnd the strain

the nucleus tion. If an intenosis.

ly to the spi

egeneration ahat don't get

neck herniatfrom daily ainside the dtervertebral

inal cord

and disc hernblood have

tes. Normallactivities. Hodisc may rupt

disc herniate

niation can cless oxygen

ly, the shockowever, if thture throughes straight b

choke off theand don't fu

k-absorbing dhe pressure oh the outer anbackward, it

e blood suppunction norm

disc is able ton the disc isnnulus and scan press ag

ply that goesmally, leading

to handles too stroqueeze o

gainst the

to the spg to sym

Sympto

What do

Cervical main cauinjury or

The first their neckway they

Most patclumsy wbecause t

Shoulderpart of ththe shoul

The area hand. Th

oms

oes cervical

stenosis usuuse of spinal

a herniated

sign to appek. But pressu

y walk. Even

tients also hawhen doing fthe muscles

r weakness ahe neck. Moslder. These m

where the sphe problem th

stenosis fee

ually developstenosis. Sydisc may ca

ear in some pure on the sp

ntually their w

ave problemsfine motor acalong the in

also developsst affected armuscles wea

pinal cord ishat compress

el like?

ps slowly ovymptoms rareause symptom

patients is a pinal cord inwalking patt

s in their hanctivities like

nside edge of

s in many pare the should

aken and beg

s compressedses the spina

ver a long peely appear alms to come o

change in thn the neck catern gets jerk

nds. The mae writing or tf the palm an

atients. This der blade mugin to show s

d in patients al cord in the

eriod of timell at once whon immediat

he way they an affect the ky and they

ain complaintyping. The and fingers w

happens mouscles and thsigns of wast

with stenose neck may a

. This is parthen degenertely.

walk. They nerves and mlose muscle

nt is that theirability to grieaken.

ost often whehe deltoid muting (atrophy

is is very cloalso affect th

tly because dation is caus

don't realizemuscles in thpower in th

r hands startip and let go

en the spinaluscle, which

hy) from not

ose to the nehe nerves wh

degenerationsing the prob

e this problemhe legs, leade legs. This

t to feel num of items bec

l cord is comh covers the tgetting nerv

erves that gohere they lea

n in later blems. A

m is comding to chis called

mb. Othercomes di

mpressed top and o

ve input.

to the arave the sp

column. Nerve pressure can cause pain to radiate from the neck to the shoulder, upper back, or even down one orIt can also cause numbness on the skin of the arm or hand and weakness in the muscles supplied by the nerve.

Pressure against the spinal cord also creates problems with the bowels and bladder. Mild spinal cord pressure malike you have to urinate more often. But it also makes it difficult to get urine to flow (urinary hesitancy). Moderadisturbances cause people to have a weak flow of urine, making them dribble urine. They also have to strain durimovements. In severe cases, people aren't able to voluntarily control their bladder or bowels. This is called incon

Diagnosis

How will my health care provider identify the condition?

Diagnosis begins with a complete history and physical exam. When you first visit BodyZone Physiotherapy, our physiotherapist will ask questions about your symptoms and how your problem is affecting your daily activities. include questions about pain, feelings of numbness or weakness, changes in bowel or bladder function, and whetnoticed any changes in the way you walk.

Our physiotherapist then does a physical examination to see which neck movements cause pain or other symptomskin sensation, muscle strength, and reflexes are tested. We will also watch you walk to see if there are any subtlyour walking pattern.

Some patients may be referred to a doctor for further diagnosis. Once your diagnostic examination is complete, tphysiotherapists at BodyZone Physiotherapy have treatment options that will help speed your recovery, so that yquickly return to your active lifestyle.

BodyZone Physiotherapy provides services for physiotherapy in Calgary.

Our Treatment

Non-surgical Rehabilitation

Spinal myelopathy is a serious condition. If your condition is causing significant problems or is rapidly getting wmay not begin with nonsurgical treatments and instead recommend you see a doctor to explore surgical options iIf the symptoms are mild, your BodyZone physiotherapist may initially try nonsurgical treatment to see if the syimprove.

Although the length of treatment is different for each individual, as a general guideline, BodyZone Physiotherapywith mild symptoms of cervical myelopathy typically undergo rehabilitation for three to six months.

At first, we may suggest immobilizing the neck. Keeping your neck still for a short time can calm inflammation We instruct patients to restrict their daily activities by avoiding heavy and repeated motions of the neck, arms, anbody.

Our theraplace by to taper tresume th

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After initelectricalgently strphysiothe

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X-rays arspace bet

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the spinal cof a bone spur

magnetic resues of the bodtes pictures t

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as part of an

ages can shoagainst the

aging (MRI) t gives a cleae slices of th

n ongoing ho

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MRI machthe spinadoctor is

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ctor may recheck if the m

l (SSEP) testa nerve is abecorded with.

tients are givspace. This that injectingand give the

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ory informativer the skin o

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m.

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es that go to g correctly. Dspinal cord iion such as por with a nee

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an is a detailnal column a

your arm anDoctors mayis getting sqpain, temperedle that is in

ction is giveovers the sp

mmation arou

led X-ray thaand taking up

nd hand. An y also order aqueezed. Therature, and tonserted into

en in a part oinal cord) anund the nerv

at lets doctorp space arou

electromyoga somatosense SSEP is useouch. The futhe nerve or

of the spinal nd the spinalves and discs

rs see sliund the sp

graphy (Esory evoked to me

unction osensory

canal call column. This ca

Surgery

When theused to tr

la an co

Laminec

The lamicord. Whin order t

Some surplace by A secondand the okeeps pre

y

ere are signsreat spinal st

aminectomy nterior cerviorpectomy a

ctomy

ina is the covhen bone sputo release pr

rgeons compforming a h

d cut is madeother edge acessure off th

s that pressurtenosis inclu

ical discectomand strut graf

vering layer urs or disc coessure on th

pletely remoinge on one e all the waycts like a hine spinal cord

re is buildingude

my and fusioft

of the bony ontents havee spinal cord

ve the entireedge of the

y through thenge. The hingd.

g on the spin

on

ring of the se pushed intod.

e lamina bonbone. This h

e lamina on tged side eve

nal cord, sur

spinal canal.o the spinal c

ne, called tothinge is formthe other sidntually form

rgery may be

It forms a rcanal, a lami

tal laminectomed by cuttinde. This edgems a bone un

e required, so

roof-like struinectomy is d

omy. Others ng partially te is then lifte

nion, which h

ometimes rig

ucture over thdone to take

prefer to kethrough the led away fromholds the opp

ght away

he back ooff the l

ep the lamlamina om the spiposite sid

Total

Hinge

Lamine

e

ectomy

A fusion of the nethe flat su

surgery joinck. The surgurfaces of th

ns two or mogeon takes ouhe two verteb

ore bones intut the intervebrae to be fu

to one solid bertebral disc

used. This ca

bone. Fusionc (discectomyauses the sur

Anterio

n of the necky) between t

rfaces to blee

or Cervical D

k bones is mtwo vertebraed and stimu

Discectomy

most often doae. A layer oulates the bon

and Fus

ne througf bone isne to hea

similar tobone andspinal co

Corpecto

A corpecthe spinascrews ar

Corpe

 

o the way twd inserted intord. As the bo

omy and St

ctomy relieveal column anre generally

ectomy

wo sides of a to the space wone graft hea

rut Graft

es pressure od removes sused to hold

fractured bowhere the dials in place,

over a large everal verteb

d the spine in

one begin to isc was takenthe vertebra

part of the spbral bodies. n place while

heal.) A secn out. This sal bones fuse

pinal cord. IThe spaces e it heals. A

ction of boneseparates thee together in

In this proceare then fille corpectomy

e is grafted fe two vertebrnto one solid

edure, the sured with boney is used in c

from the top ra bones, takbone.

rgeon takes e graft matercases of seve

part of thking pres

off the frrial. Metaere spinal