Congenital Cervical Stenosis: a Review of the Current Literature

Abstract

Purpose of review: Congenital cervical stenosis (CCS) is a phenomenon in which an individual has a narrow canal due to abnormal anatomy which can present with earlier degenerative symptoms due to a reduced sagittal diameter. The diagnosis of CCS is important to individual treatment and preventative measures. Often, athletes are warned against sport participation that may cause damage to the cervical spine. There may be a predisposition in certain populations, but lack of data limits conclusions. The current review investigates recent literature on the definition, pathoanatomy, clinical presentation, and management of CCS. It specifically interrogates potential populations predisposed to this condition.

Recent findings: The current literature reveals a potential predisposition for CCS in the black population when compared to the white population; however, many studies do not report race when discussing CCS patients. The lack of data limits a consensus on specific populations with a congenitally narrow canal. CCS may be more prevalent in specific populations. With knowledge of populations more at risk for this condition, physicians and teams can be alert when evaluating players and young adults. Furthermore, this may provide insight into risk for symptoms with degenerative disease. These findings introduce an avenue for further research into CCS.

Keywords: Adjacent segment degeneration; Congenital cervical stenosis; Genetic syndromes; Transient quadriplegia.

Fig. 1

A plain lateral radiograph illustrating the vertebral body diameter and spinal canal diameter measurements that comprise the Torg-Pavlov ratio (canal-body ratio) [17]. Courtesy of Nouri et al. Labeled for reuse and published with permission from Elsevier

Fig. 2

Spinal cord occupation ratio (SCOR) measurements on MRI. SCOR takes the ratio of diameter of cord above and cord below divided by canal above and canal below. SCOR = $\frac{cordabove+cordbelow}{canalabove+canalbelow}$  × 100 [17]. Courtesy of Nouri et al. labeled for reuse according to and published with permission from Elsevier

Fig. 3

Triangle model comparing measurements between a CCS and control patient. The posterior canal distance (PCD) with AP lateral mass (LM) composes the spinal canal diameter (SCD). Lamina-pedicle angle (LPA) is formed by the intersection of the and the laminar length (LL) (hypotenuse). Lamina-disk angle (LDA) is formed by the intersection of the SCD and the LL [2]. Courtesy of Jenkins et al. published with permission from Wolters Kluver