Spinal stenosis refers to when the spinal canal becomes too narrow and causes compression of the contents within it. Cervical stenosis can be congenital (developmental) or degenerative, as a result of arthritis, disc herniations, or thickening of the ligaments. In some cases, the ligament becomes calcified or ossified (referred to as OPLL, or ossified posterior longitudinal ligament).

In the cervical spine, compression of the spinal cord can result in weakness, numbness, and tingling in the hands, arms, and occasionally the legs. Clumsiness and difficulty walking may ensue, and longstanding or severe spinal cord compression can lead to incontinence and inability to stand or walk. In some cases, the arms and legs become stiff or spastic.

Some people are born with a narrow cervical spinal canal, and this is referred to as congenital stenosis. People with congenital stenosis have less "reserve" when it comes to disc bulges or other sources of compression, so they may develop symptoms sooner or more severe symptoms compared to people with normal spinal canals.

Surgery is the treatment of choice for symptomatic cervical stenosis. Anterior compression from disc herniations or thickened ligament can be addressed from an anterior approach, whereas multilevel stenosis, particularly congenital stenosis, and some cases of foraminal/neuroforaminal stenosis can be treated with a posterior decompression.