Coexisting lumbar and cervical stenosis (tandem spinal stenosis): an infrequent presentation. Retrospective analysis of single-stage surgery (53 cases)

Krishnan, Ajay; Dave, Bharat R; Kambar, Arun Kumar; Ram, Himanshu

doi:10.1007/s00586-013-2868-4

Cited by 49 publications

(52 citation statements)

References 28 publications

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“…There is limited evidence to support the use of singlestage versus staged decompression for disseminated spinal stenosis [8,9,[13][14][15][16][17][18][19]. Our strategy for TM with coexistent cervical and/or lumbar lesions is to perform single-stage decompression of all associated spinal lesions; therefore, we cannot compare surgical outcomes of these cases to those undergoing staged surgery.…”

Section: Discussionmentioning

confidence: 99%

Single-stage surgery for compressive thoracic myelopathy associated with compressive cervical myelopathy and/or lumbar spinal canal stenosis

et al. 2015

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Section: Discussionmentioning

confidence: 99%

Single-stage surgery for compressive thoracic myelopathy associated with compressive cervical myelopathy and/or lumbar spinal canal stenosis

et al. 2015

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“…The controversial nature of the treatment process for TSS can be seen in many cases in which the secondary condition becomes more evident after surgical treatment of the primary condition [1,6,12]. Some authors suggest that the order of surgical decompression should be determined by the location of the more severe symptoms and recommend deferring to cervical decompression in cases that are unclear [1,6,13].…”

Section: Discussionmentioning

confidence: 99%

Relief of Lumbar Symptoms After Cervical Decompression in Patients with Tandem Spinal Stenosis Presenting with Primarily Lumbar Pain

Felbaum

Fayed

Stewart

et al. 2016

Cureus

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Objective: Tandem cervical and lumbar spinal stenosis (TSS) is classically described as intermittent claudication, gait disturbance, and clinical findings of mixed myelopathy and polyradiculopathy. Rarely, patients can present with TSS manifesting in isolated lumbar pain. Several reports have demonstrated improved lumbar back pain and radiculopathy after decompressive cervical spine procedures. We present six patients with dramatic resolution of lumbar spine related symptoms after decompression of the cervical spinal cord despite presenting solely with lower back complaints.Methods: Clinical records of the senior author (F.A.S.) gathered from April 2006 to March 2013 were retrospectively reviewed identifying six patients presenting solely with lumbar symptoms and diagnosed with TSS based on history and physical examination.Results: Six patients with a mean age of 55 (range 39 to 60) presented with solely lower back symptoms and clinical findings suspicious for TSS. Mean follow-up time for all patients was 12 months (range three to 27 months, median 11.5 months). Three patients underwent a cervical procedure as the principal operation, while the remainder had the lumbar spine decompressed initially. All patients that underwent a cervical procedure initially experienced a dramatic decrease or complete resolution of their preoperative lower back pain and radiculopathy (mean preoperative VAS of 6.7 vs. 3.7 postoperative). The remainder of patients with persistent lumbar symptoms resolved after a subsequent cervical operation.Conclusion: Patients presenting with lumbar symptoms out of proportion to imaging require further investigation. We highlight the resolution of lumbar symptoms after a cervical procedure in a select group of patients presenting with lone lower back complaints. In patients presenting with symptoms disproportionate to lumbar imaging, treatment of cervical pathology may provide robust long-term relief of the initial lumbar-related presentation.

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“…3). In the patients with coexisting lumbar and cervical stenosis (tandem spinal stenosis), history-taking and physical examination are not definitive; a mixture of upper and lower motor neuron findings may exist clinically [18]. …”

Section: Make Sure That the Offender Is The Main Culpritmentioning

confidence: 99%

Ten Important Tips in Treating a Patient with Lumbar Disc Herniation

2016

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Lumbar disc herniation is a common spinal disorder that usually responds favorably to conservative treatment. In a small percentage of the patients, surgical decompression is necessary. Even though lumbar discectomy constitutes the most common and easiest spine surgery globally, adverse or even catastrophic events can occur. Appropriate patient selection and effective neural decompression constitute the most important points for better surgical outcomes and avoidance of unpleasant complications. Other important tips include timely performance of magnetic resonance imaging, correct interpretation of scan data, preoperative detection of underlying instability, exclusion of non-discogenic sciatica, determination of the main cause of clinical pathology, avoidance of the wrong side or level, and being sure that the more detailed procedure does not necessarily mean the more effective procedure.

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Coexisting lumbar and cervical stenosis (tandem spinal stenosis): an infrequent presentation. Retrospective analysis of single-stage surgery (53 cases)

Cited by 49 publications

References 28 publications

Single-stage surgery for compressive thoracic myelopathy associated with compressive cervical myelopathy and/or lumbar spinal canal stenosis

Single-stage surgery for compressive thoracic myelopathy associated with compressive cervical myelopathy and/or lumbar spinal canal stenosis

Relief of Lumbar Symptoms After Cervical Decompression in Patients with Tandem Spinal Stenosis Presenting with Primarily Lumbar Pain

Ten Important Tips in Treating a Patient with Lumbar Disc Herniation

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