Cervical Spine Orthopedics II Practice Exam

Central canal stenosis typically presents with which type of clinical presentation compared to foraminal stenosis?

Central canal stenosis presents with myelopathy (gait disturbance and brisk reflexes); foraminal stenosis presents with radicular pain and numbness Central canal stenosis presents with isolated neck pain; foraminal stenosis presents with myelopathy Central canal stenosis presents with radicular pain only; foraminal stenosis presents with gait disturbance Central canal stenosis presents with lower motor neuron signs; foraminal stenosis presents with upper motor neuron signs

Correct Answer:

Central canal stenosis presents with myelopathy (gait disturbance and brisk reflexes); foraminal stenosis presents with radicular pain and numbness

Explanation:

Central canal stenosis in the cervical spine compresses the spinal cord, leading to myelopathy. That means signs of upper motor neuron impairment such as gait disturbance and brisk reflexes. In contrast, foraminal stenosis narrows the exit for a nerve root, producing radiculopathy with radicular pain and numbness in a dermatomal distribution. So the classic contrast is central canal stenosis causing myelopathy and foraminal stenosis causing radicular symptoms. The described pattern—central canal stenosis with myelopathy and foraminal stenosis with radicular pain and numbness—fits this distinction. The other patterns don’t align with how cord versus nerve-root compression typically presents (central with UMN features; foraminal with radicular symptoms).

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