Does the Degree of Stenosis Affect Cervical Proprioception in Patients With Cervical Problems?

With the increase in technology, the use of computers in the workplace is becoming widespread all over the world. With the use of computers in offices, long-term computer exposure of employees at the desk has emerged. In recent years, the use of computers is not only limited to offices, but the concept of working remotely from home is becoming increasingly widespread as a result of extraordinary conditions such as pandemics and earthquakes. Long-term work at the desk causes various musculoskeletal disorders. These musculoskeletal system disorders, which develop due to working life, were first mentioned by Bernardino Ramazini in the 17th century in his book "Occupational Diseases", including the pain in the hands of bakery workers and posture disorders of desk workers. Repetitive movements and static posture, use of wrong body mechanics and inadequate ergonomic conditions play a role in the development of musculoskeletal disorders in desk workers. In addition to these, stress experienced at work is also effective in musculoskeletal disorders. Neck pain is the most common complaint in desk workers. When neck musculoskeletal complaints are investigated, neck pain is seen in the first place with a high rate of 65.7%. In addition, it has been reported that 22% of the employees have head, neck and back pain in different parts of the individuals due to the high duration of time spent in sitting position.

Degenerative problems frequently occur in the cervical spine. Cervical spondylosis, cervical degenerative disc disease / disc herniation, cervical spondylotic myopathy conditions, which are frequently seen due to degeneration in the cervical spine, cause canal narrowing in the cervical region. Cervical spinal canal being narrower than normal is defined as cervical spinal stenosis. Cervical spinal stenosis causes a variety of symptoms depending on its severity. The most common symptom of cervical spinal stenosis is neck pain, which may be accompanied by stiffness and limited range of motion. Other symptoms may include abnormal reflexes in the upper limbs, cervical spine pain, nerve root compression in the cervical region, cervical cord compression, numbness or tingling in the arms, hands, legs or feet, weakness in the arms, hands, legs or feet, difficulty with coordination and balance, and in severe cases, loss of bladder or bowel control.

The diagnosis of cervical spinal stenosis is made by evaluating the patient's medical history, physical examination findings and imaging tests. Firstly, the patient's symptoms such as neck pain, numbness, weakness in arms and legs are questioned. Previous injuries and medical conditions that may cause symptoms are also questioned. In the physical examination, findings related to spinal cord compression such as abnormal reflexes or muscle weakness are evaluated. Other tests may also be performed to assess the patient's range of motion or the function of the spinal cord and nerve roots.

Imaging tests, such as magnetic resonance imaging (MRI) or computed tomography (CT) scans, can provide detailed images of the spine and help determine the location and severity of stenosis. In a study on the role of MRI in guiding the diagnosis and treatment of cervical spinal stenosis syndromes, it was found that there was an agreement between the clinical presentation of cervical canal stenosis and imaging findings.

Symptoms of cervical spinal stenosis are diverse and can include both sensory and motor impairments. A case study in the literature of a person with severe cervical spinal stenosis showed that the patient had difficulty walking, weakness in the right leg and unsteadiness in walking. Sensory examination revealed mild tactile pain and decreased proprioception. In addition, another study investigating the effectiveness of MRI in diagnosis and treatment showed that one of the most common symptoms in patients with cervical canal stenosis was the presence of abnormal reflexes in the tendons of the upper extremities. These studies show the potential effects of cervical spinal stenosis on proprioception.