Lumbar Decompression Surgery

Outcomes in Surgical Treatment for Tandem Spinal Stenosis: Systematic Literature Review Research Article

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Published article

CONCLUSION: Staged and simultaneous surgery for TSS have comparable perioperative, functional and neurologic outcomes, as well as complication rates. Careful selection of candidates for simultaneous surgery may reduce length of stay and consolidate rehabilitation, thereby reducing hospital associated costs.
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Spine J. 2022 Jul 14:S1529-9430(22)00791-4. doi: 10.1016/j.spinee.2022.07.088. Online ahead of print.

ABSTRACT

BACKGROUND CONTEXT: Tandem Spinal Stenosis (TSS) refers to narrowing of the spinal canal in distinct, non-contiguous regions. TSS most commonly occurs in the cervical and lumbar regions. Decompressive surgery is indicated for those with cervical myelopathy or persistent symptoms from lumbar stenosis despite conservative management. Surgical management typically involves staged procedures, with cervical decompression taking precedence in most cases, followed by lumbar decompression at a later time. However, several studies have shown favorable outcomes in simultaneous decompression.

PURPOSE: The aim of this study is to provide a literature review and compare surgical outcomes in patients undergoing staged vs simultaneous surgery for TSS.

STUDY DESIGN/SETTING: Systematic literature review.

METHODS: A systematic review using PRISMA guidelines to identify original research articles for Tandem Spinal Stenosis. PubMed, Cochrane, Ovid, Scopus, and Web of Science were used for electronic literature search. Original articles from 2005-2021 with more than 8 adult patients treated surgically for cervical and lumbar TSS in staged or simultaneous procedures were included. Articles including pediatric patients, primarily thoracic stenosis, stenosis secondary to neoplasm or infectious disease, minimally invasive surgery and non-English language were excluded. Demographic, perioperative, complications, functional outcome and neurologic outcome data including mJOA (modified Japanese Orthopaedic Association), Nurick grade (NG), ODI (Oswestry disability index), were extracted and summarized.

RESULTS: A total of 667 articles were initially identified. After preliminary screening, 21 articles underwent full-text screening. Ten articles met our inclusion criteria. A total of 831 patients were included, 571 (68%) of them underwent staged procedures, and 260 (32%) underwent simultaneous procedures for TSS. Mean follow-ups ranged from 12-85 months. There was no difference in estimated blood loss (EBL) between staged and simultaneous groups (p=0.639). Simultaneous surgeries had shorter surgical time than staged surgeries (p<0.001). Mean changes in mJOA, NG and ODI were comparable between staged and simultaneous groups. Complications were similar between the groups. There were more major complications reported in simultaneous operations, although this was not statistically significant (p=0.301).

PMID:35843535 | DOI:10.1016/j.spinee.2022.07.088

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Outcomes in Surgical Treatment for Tandem Spinal Stenosis: Systematic Literature Review

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2022-06-08

Truly excellent results! I was diagnosed with lumbar stenosis after experiencing increasing pain in both legs. An MRI and consultation carried out at short notice confirmed this. Mr Akmal recommended that a spacer should be inserted in my lower back to correct the problem and release the nerves from the narrowing caused by stenosis. The operation was conducted very professionally and without pain. After the first two weeks the pain started to subside as expected. After 4 weeks I was completely back to normal. The result is exceptionally good and I feel renewed, with no pain whatsoever and a regained posture, ready to resume a normal life. I cannot recommend The London Spine Unit highly enough. They are medical magicians!

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2022-05-18

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2022-05-18

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2022-04-22

I had a massive bulging disk on my back… I had a massive bulging disk on my back compressing my nerve for three years. It caused me excruciating pain and almost left me disabled. I was on both crutches and completely homebound due to the severity of pain and mobility limitations. I had my lumber surgery two weeks ago and walked out of hospital within a few hours pain free on my right leg that was almost paralysing prior to surgery. The disk was shaved off releasing the nerve completely. Two days after surgery I had excruciating pain on my head that is unexplained as I had CT scan and MRI which were all fine. Dr Akmal has suggested it could be from the anaesthetic. I am extremely grateful to Dr Akmal and his very welcoming and cari g team. I would highly recommend his clinic as I have had excellent recovery.

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2022-04-02

Thank you Mr Aklam After having a poor and very slow experiance in glasgow . I contacted Mr mo Amlam . Who is a true gentleman, great listener and paitent . We transfered my scans and treatments from glasgow to harley street . Mr Aklams p.a arranged a quick zoom to start our contact .I then went down for a meeting and examination and what should have been a spec scan .only to be told of a UK shortage . So 4 weeks later the scan took place in wellington hospital . Before I traveled back to glasgow. 5 days later I got a call to book me in to 19 harley street for a l3 and l4 debridement and stabilisation. The opp took place on 24th March. 2hours I was out walking 4 hours later . My pain in back groin and foot was all gone .thanks to Mr aklam . Top of his craft but more importantly pouts his patients first .he really wants to help you get better. Thank you so much Mr Robert harvey

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2022-03-22

Amazing service and an amazing treatment! I can't thank Mr Akmal and team at the London Spine Unit enough for their help. I had a herniated disc in my back which was causing pain and restrictions. Compared to other offers of surgery (e.g. several nights in hospital), the day surgery and minimally invasive procedure were hugely appealing. I am now 3 weeks post surgery, have no pain and am recovering incredibly quickly if I compare myself to friends who have had a similar procedure. it was truly remarkable, straightforward and the team were kind, friendly and always helpful. very highly recommended!

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2022-03-17

Great service and painless procedure Great service and painless procedure. Definitely alleviated the pain

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Spine J. 2022 Jul 14:S1529-9430(22)00791-4. doi: 10.1016/j.spinee.2022.07.088. Online ahead of print.ABSTRACTBACKGROUND CONTEXT: Tandem Spinal Stenosis (TSS) refers to narrowing of the spinal canal in distinct, non-contiguous regions. TSS most commonly occurs in the cervical and lumbar regions. Decompressive surgery is indicated for those with cervical myelopathy or persistent symptoms from lumbar stenosis despite conservative management.…