Cervical Stenosis and Falls: Will You Become Paralyzed?

by Chris Centeno, MD /

Receive a Regenexx® Patient Info Packet by email and learn why it's a superior regenerative solution.

falls with neck stenosis paralysis

One of the more interesting things I hear from patients with cervical stenosis is that some spine surgeon told them that the risk of becoming paralyzed with a routine fall means they need surgery right now! This is personal for me, as I have tight cervical stenosis and have chosen not to have surgery. So what are the odds of this really happening? Let’s dig in.

What is Cervical Stenosis?

Your spinal cord goes through the neck bones. That hole for the spinal cord is called the central canal and it can get smaller making it a tight fit for the cord. That can happen due to disc bulges, bone spurs, arthritic facet joints, or enlarged and swollen ligaments. You can even be born with a tight central canal. See my video below for an explanation of how that works:

This tightness can irritate the spinal cord and lead to all sorts of symptoms. Everything from numbness, tingling, weakness, or aches and pains elsewhere. When this happens, this is called symptomatic spinal stenosis.

Selling Surgery

I don’t know how many patients I have seen through the years who have told me that a spine surgeon claimed that if they didn’t get neck surgery sooner rather than later, they could become paralyzed from a simple fall. Yesterday, I had a patient who recognized me at our local Whole Foods. He relayed that a surgeon at a famous Colorado sports medicine clinic told him that this is why he needed surgery. Despite everything I know, what ran through my mind in a split second was that I have stenosis in my neck and could this happen to me? After all, I was about to get into my car! Meaning this stuff is scary, even for a physician. Hence, I decided this would make a great deep dive blog topic.

What are the Odds of Paralysis?

My sense from practicing medicine for several decades and never having seen one of my own severe cervical stenosis patients become a quadriplegic from a fall was that this risk was very small. However, despite searching this in the past a few times on the US National Library of Medicine, I had never seen a study that directly addressed this issue. However, yesterday I finally found a few that answered this question. So is this a real risk, or just a surgical sales pitch?

First, in 2006, someone actually attempted to calculate the risk of becoming paralyzed from an injury just because there was severe spinal stenosis. After an extensive review of multiple demographic and medical databases, they put that “worst case scenario” (likely overestimate) risk at 1:2100 (1). However, the risk of surgical neck decompression is far worse (2). In fact, serious complications vary from approximately 1 in 200 for spinal cord or nerve root injury to 1 in 100 for infection to 1 in 7 for “Adjacent Segment Disease”. Hence, you are about 10-20 times more likely to be seriously injured by neck surgery than you are by falling and becoming paralyzed!  As a result of this, the authors of a recent analysis on the topic concluded that there was no evidence to support surgery to decompress the spinal cord to prevent possible paralysis from a fall. (3).

How Do Other Real World Odds Compare?

If the odds of becoming paralyzed from a fall or car crash because you have cervical spinal stenosis are generously 1 in 2,100, how does that compare to common risks? Below is a table that shows all of the things you’re more likely to die from in your lifetime than get paralyzed from a fall (4):

risk of death vs paralysis from neck stenosis

Again, you are 20 times more likely to die in a car crash than become paralyzed from a fall!

The upshot? The idea that you need neck surgery to decompress your spinal cord if you have neck stenosis because you may become paralyzed in a fall is ridiculous. This assertion is NOT supported by any scientific review of the data. As shown, you are far more likely to get killed by all sorts of stuff, including driving to the grocery store than becoming paralyzed this way. More importantly, the risk of the surgery making you paralyzed or seriously injuring you is far greater than the risk from a fall. Hence, note to my surgical colleagues, please STOP the surgery scare (sales) tactics!

_____________________________________

References:

  1. Lauryssen, C., K. D. Riew, and J. C. Wang. “Severe cervical stenosis: Operative treatment of continued conservative care.” Spine Line 8.1 (2006): 21-5.
  2. Cheung, Jason Pui Yin, and Keith Dip-Kei Luk. “Complications of Anterior and Posterior Cervical Spine Surgery.” Asian spine journal vol. 10,2 (2016): 385-400. doi:10.4184/asj.2016.10.2.385
  3. Murphy, Donald R et al. “Cervical spondylosis with spinal cord encroachment: should preventive surgery be recommended?.” Chiropractic & osteopathy vol. 17 8. 24 Aug. 2009, doi:10.1186/1746-1340-17-8
  4. Insurance Information Institute: https://www.iii.org/fact-statistic/facts-statistics-mortality-risk
Category: Neck/Cervical

Leave a Reply

Your email address will not be published. Required fields are marked *

2 thoughts on “Cervical Stenosis and Falls: Will You Become Paralyzed?

  1. Kaye Preston

    Have NEVER been told that I needed surgery. Thank you. Am still seeing the medical profession and hope to get an answer!!.

  2. Chad Medeiros

    Thanks Dr. Chris,
    That was I that you met at Whole Foods. I guess we were supposed to me!

    Thanks to both our Soul Guides!! Good looking out!
    Ps, I’ll let you know what the Spine Dr. suggest this Wed….

Chris Centeno, MD

Regenexx Founder

Chris Centeno, MD is a specialist in regenerative medicine and the new field of Interventional Orthopedics. Centeno pioneered orthopedic stem cell procedures in 2005 and is responsible for a large amount of the published research on stem cell use for orthopedic applications.
View Profile

Get Blog Updates by Email

Get fresh updates and insights from Regenexx delivered straight to your inbox.

Regenerative procedures are commonly used to treat musculoskelatal trauma, overuse injuries, and degenerative issues, including failed surgeries.
Select Your Problem Area
Shoulder

Shoulder

Many Shoulder and Rotator Cuff injuries are good candidates for regenerative treatments. Before considering shoulder arthroscopy or shoulder replacement, consider an evaluation of your condition with a regenerative treatment specialist.

  • Rotator Cuff Tears and Tendinitis
  • Shoulder Instability
  • SLAP Tear / Labral Tears
  • Shoulder Arthritis
  • Other Degenerative Conditions & Overuse Injuries
Learn More
Cervical Spine

Spine

Many spine injuries and degenerative conditions are good candidates for regenerative treatments and there are a number of studies showing promising results in treating a wide range of spine problems. Spine surgery should be a last resort for anyone, due to the cascade of negative effects it can have on the areas surrounding the surgery. And epidural steroid injections are problematic due to their long-term negative impact on bone density.

  • Herniated, Bulging, Protruding Discs
  • Degenerative Disc Disease
  • SI Joint Syndrome
  • Sciatica
  • Pinched Nerves and General Back Pain
  • And more
Learn More
Knee

Knees

Knees are the target of many common sports injuries. Sadly, they are also the target of a number of surgeries that research has frequently shown to be ineffective or minimally effective. Knee arthritis can also be a common cause for aging athletes to abandon the sports and activities they love. Regenerative procedures can be used to treat a wide range of knee injuries and conditions. They can even be used to reduce pain and delay knee replacement for more severe arthritis.

  • Knee Meniscus Tears
  • Knee ACL Tears
  • Knee Instability
  • Knee Osteoarthritis
  • Other Knee Ligaments / Tendons & Overuse Injuries
  • And more
Learn More
Lower Spine

Spine

Many spine injuries and degenerative conditions are good candidates for regenerative treatments and there are a number of studies showing promising results in treating a wide range of spine problems. Spine surgery should be a last resort for anyone, due to the cascade of negative effects it can have on the areas surrounding the surgery. And epidural steroid injections are problematic due to their long-term negative impact on bone density.

  • Herniated, Bulging, Protruding Discs
  • Degenerative Disc Disease
  • SI Joint Syndrome
  • Sciatica
  • Pinched Nerves and General Back Pain
  • And more
Learn More
Hand & Wrist

Hand & Wrist

Hand and wrist injuries and arthritis, carpal tunnel syndrome, and conditions relating to overuse of the thumb, are good candidates for regenerative treatments. Before considering surgery, consider an evaluation of your condition with a regenerative treatment specialist.
  • Hand and Wrist Arthritis
  • Carpal Tunnel Syndrome
  • Trigger Finger
  • Thumb Arthritis (Basal Joint, CMC, Gamer’s Thumb, Texting Thumb)
  • Other conditions that cause pain
Learn More
Elbow

Elbow

Most injuries of the elbow’s tendons and ligaments, as well as arthritis, can be treated non-surgically with regenerative procedures.

  • Golfer’s elbow & Tennis elbow
  • Arthritis
  • Ulnar collateral ligament wear (common in baseball pitchers)
  • And more
Learn More
Hip

Hip

Hip injuries and degenerative conditions become more common with age. Do to the nature of the joint, it’s not quite as easy to injure as a knee, but it can take a beating and pain often develops over time. Whether a hip condition is acute or degenerative, regenerative procedures can help reduce pain and may help heal injured tissue, without the complications of invasive surgical hip procedures.

  • Labral Tear
  • Hip Arthritis
  • Hip Bursitis
  • Hip Sprain, Tendonitis or Inflammation
  • Hip Instability
Learn More
Foot & Ankle

Foot & Ankle

Foot and ankle injuries are common in athletes. These injuries can often benefit from non-surgical regenerative treatments. Before considering surgery, consider an evaluation of your condition with a regenerative treatment specialist.
  • Ankle Arthritis
  • Plantar fasciitis
  • Ligament sprains or tears
  • Other conditions that cause pain
Learn More

Is Regenexx Right For You?

Request a free Regenexx Info Packet

REGENEXX WEBINARS

Learn about the #1 Stem Cell & Platelet Procedures for treating arthritis, common joint injuries & spine pain.

Join a Webinar

RECEIVE BLOG ARTICLES BY EMAIL

Get fresh updates and insights from Regenexx delivered straight to your inbox.

Subscribe to the Blog

FOLLOW US

Copyright © Regenexx 2019. All rights reserved. | Privacy Policy

*DISCLAIMER: Like all medical procedures, Regenexx® Procedures have a success and failure rate. Patient reviews and testimonials on this site should not be interpreted as a statement on the effectiveness of our treatments for anyone else.

Providers listed on the Regenexx website are for informational purposes only and are not a recommendation from Regenexx for a specific provider or a guarantee of the outcome of any treatment you receive.