Surgical outcomes for lumbar spinal canal stenosis with coexisting cervical stenosis (tandem spinal stenosis): a retrospective evaluation of 565 instances.
J Orthop Surg Res. 2018 Mar 20;13(1):60
Authors: Yamada T, Yoshii T, Yamamoto N, Hirai T, Inose H, Okawa A
BACKGROUND: Concurrent cervical and lumbar spinal canal stenosis is named tandem spinal stenosis (TSS). As analysis on TSS is proscribed, there is no such thing as a consensus on the optimum surgical method to this downside. We evaluated the prevalence and scientific traits of TSS in sufferers with symptomatic lumbar spinal canal stenosis (LCS).
METHODS: The authors carried out a retrospective evaluation of the outcomes of 565 sufferers who underwent lumbar surgical procedures carried out for symptomatic LCS. In all of the sufferers, each the cervical and lumbar areas had been evaluated preoperatively, and we in contrast TSS sufferers and non-TSS sufferers when it comes to a number of scientific parameters. Within the TSS sufferers, we investigated the ratio and scientific outcomes of extra cervical surgical procedures carried out on TSS sufferers.
RESULTS: 2 hundred two instances (35.eight%) had been thought-about to be TSS. Twenty-eight sufferers (5.zero%) underwent a cervical operation in the course of the follow-up interval. There have been no variations between the radiographic TSS sufferers and non-TSS sufferers when it comes to preoperative lumbar-Japanese Orthopedic Affiliation (L-JOA) scores, postoperative L-JOA scores, and the L-JOA restoration fee (14.eight?±?four.four factors vs 14.2?±?four.6 factors, 23.9?±?four.three factors vs 23.1?±?four.5 factors, 63.7?±?28.2% vs 60.three?±?27.9%, respectively), whereas the TSS group included a higher variety of hypertension instances. The restoration fee L-JOA scores of sufferers who underwent extra cervical surgical procedures had been considerably decrease in contrast with the speed of sufferers who skilled remedy for under lumbar lesions (62.eight?±?25.eight% vs 39.eight?±?35.5%, p =?zero.0003). Nonetheless, extra cervical surgical procedure nonetheless improved each the cervical myelopathy-Japanese Orthopedic Affiliation (C-JOA) and L-JOA scores in TSS sufferers with symptomatic cervical lesion (from 10.three?±?2.eight factors to 12.1?±?three.zero factors, p =?zero.0302; from 14.eight?±?7.three factors to 19.9?±?5.zero factors, p =?zero.0331, respectively). In these sufferers, there have been no vital variations within the restoration fee of each C-JOA and L-JOA scores between the single-stage surgical procedure group and the staged surgical procedure group (40.7?±?35.eight% vs 20.7?±?16.1%; 50.9?±?25.1% vs 34.2?±?39.three%, respectively).
CONCLUSIONS: Radiographic co-existing cervical stenosis didn’t have an effect on surgical outcomes for LCS, though symptomatic cervical lesion affected neurological rating after lumbar surgical procedure. A further surgical procedure for cervical lesion considerably improved neurological findings in TSS sufferers.
PMID: 29558952 [PubMed – indexed for MEDLINE]