Concurrent (Tandem) Cervical and Lumbar Spinal Stenosis

Abstract

With TSS, the symptoms of either the cervical or the lumbar type initially predominate. Often, only after the primary pathology is treated does the secondary problem become evident. Although TSS occurred relatively infrequently in this series, its potential presence should not be overlooked.

The Value of Additional Cervicothoracic Spine Sagittal T2-weighted Images Included in Routine Lumbar Spine MR Imaging

“…In tandem spinal stenosis, the symptoms of either the cervical or the lumbar type can overlap in such a way that the symptoms caused by cervical myelopathy might erroneously be deemed symptoms of lumbar spinal stenosis. Therefore, patients with symptom of severe lumbar spinal stenosis should be evaluated for the presence of cervical myelopathy (5,8). In our study, out of 139 patients who had pathologic lesions on CT SAG T2WIs, 40 patients (mean age, 69 years; range, 54-81 years) had concurrent cervical and lumbar spinal stenosis.…”

Presence of Undiagnosed Cervical Myelopathy in Patients referred for Surgical Evaluation of Lumbar Stenosis

“…Most often, the clinical scenario is a failure to improve after decompressive lumbar laminectomy, with delayed recognition of cervical myelopathy. 5 In this study, we sought to determine the presence of undiagnosed cervical myelopathy in patients referred to our clinic for surgical evaluation of lumbar spinal stenosis. The recognition of tandem spinal stenosis is paramount to the effective treatment of the patient and affects the sequencing, timing, and technique of surgical intervention.…”

Tandem spinal stenosis: a case of stenotic cauda equina syndrome following cervical decompression and fusion for spondylotic cervical myelopathy

“…2 Frequently it is not until after surgical correction of the primary symptomatic area that the second area of symptomatic stenosis becomes evident. 1,3 Cervical spondylotic myelopathy (CSM) is the most common cause of spinal cord injury in older adults. [4][5][6] Degenerative changes with radiographic evidence of compression are evident in up to 50% of the population older than 55, but only 10% proceed to have symptoms of nerve root or spinal cord compression.…”

“…[1][2][3] Tandem stenosis is a distinct syndrome, generally as a result of spondylotic degeneration, which results from symptomatic canal narrowing of multiple areas of the spine resulting in significant neurologic compression. [1][2][3] Typically, patients with tandem stenosis will present with signs of intermittent neurogenic claudication, progressive gait disturbance, and findings of mixed myelopathy and polyradiculopathy in both the upper and lower extremities. 2 Frequently it is not until after surgical correction of the primary symptomatic area that the second area of symptomatic stenosis becomes evident.…”

“…Lumbar spinal stenosis (LSS) is a commonly encountered condition, 17 and may also occur as a component of TSS. [1][2][3] The typical LSS patient is more likely to be male, in the fifth or sixth decade of life. 17 Clinically, the most frequent signs are leg pain, which is most often exacerbated by walking or extension and relieved with flexion; altered reflexes; weakness in a myotomal distribution; and decreased sensation to touch and vibration.…”