Management of asymptomatic cervical spinal stenosis in the setting of symptomatic tandem lumbar stenosis: A review

Ghobrial, George M.; Oppenlander, Mark E.; Maulucci, Christopher M.; Viereck, Matthew J.; Prasad, Srinivas; Sharan, Ashwini

doi:10.1016/j.clineuro.2014.06.012

Cited by 19 publications

(22 citation statements)

References 26 publications

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“…The incidence ranges from five percent to 25%, with a preponderance of cases in males greater than 50 years old [4-7]. The diagnosis of TSS may be elusive due to its varied presentation.…”

Section: Introductionmentioning

confidence: 99%

“…Patients may present with a triad of intermittent neurogenic claudication, gait disturbance, and clinical findings of mixed myelopathy and polyradiculopathy in both the upper and lower extremities [5]. However, symptoms referable to either the cervical or lumbar spine can predominate or vary in onset [7]. Decompression of either the cervical, lumbar or both regions may lead to improvement in the associated symptoms of both conditions.…”

Section: Introductionmentioning

confidence: 99%

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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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“…The incidence ranges from five percent to 25%, with a preponderance of cases in males greater than 50 years old [4-7]. The diagnosis of TSS may be elusive due to its varied presentation.…”

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

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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“…Тандемный (сочетанный, одновременный, комбинированный, параллельный, тандем-стеноз) стеноз определяется как стеноз позвоночного канала, сочетающийся одновременно в шейном и поясничном отделах позвоночника [51,56,66,91,133]. На рис.…”

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“…Тандем-стенозы шейного и поясничного отделов встречаются в 5-25 % случаев у пациентов с доминированием клинической симптоматики компрессии в одном из отделов позвоночника [41,81,89,97]. Необходимо подчеркнуть, что часто тандем-стеноз протекает без выраженных клинических симптомов, на что обращают внимание Ghobrial et al [66], проанализировав электронную базу данных PubMed (1966-2013 гг.). Lee et al [92], изучив ретроспективно 93 пациентов в возрасте 70 лет с основными симптомами нейрогенной (каудогенной) перемежающейся хромоты (claudicatio intermittens), установили в 23 % случаев бессимптомное течение стеноза шейного отдела позвоночника.…”

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“…Bednarik et al [45] на основе ретроспективного анализа 66 пациентов с нейрогенной хромотой в возрасте 50 лет показали, что прогрессирование миелопатии с отсутствием симптоматики стеноза шейного отдела повышает риск развития полноценного тандем-стеноза на 5 % каждый год. Dagi [60,66,75,91,93,135]. Показано, что при определении стеноза позвоночного канала в одном из отделов позвоночника и наличии неврологической клинической картины вероятность возникновения тандем-стеноза возрастает на 15,3 %, а с течением времени на 32,4 % [91].…”

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Isolated and Combined Degenerative Tandem Cervical and Lumbar Spinal Stenoses: Literature Review

Бывальцев¹,

Shepelev²,

Nikiforov³

et al. 2016

Hir. pozvonoč.

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Isolated and combined degenerative tandem cervical and lumbar spinal stenoses:The paper presents detailed definitions, anatomical features and analytical data on the epidemiology and etiopathogenesis of isolated lumbar and cervical spinal stenoses and their combinations (tandem stenoses). Most widely used classifications of stenosing processes of the spine, modern X-ray imaging methods for diagnosis of spinal stenosis and approaches to surgical treatment are described. Key Words: spinal canal stenosis, isolated stenosis, tandem stenosis, degenerative diseases of the spine, diagnosis, surgical treatment.Please cite this paper as: Byvaltsev VA, Shepelev VV, Nikiforov SB, Kalinin АА. Isolated and combined degenerative tandem cervical and lumbar spinal stenoses: literature review. Hir. Pozvonoc. 2016;13(2):52-61.In Russian.

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One-staged combined decompression for the patients with cervico-thoracic tandem spinal stenosis

Liu

et al. 2016

Eur Spine J

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Management of asymptomatic cervical spinal stenosis in the setting of symptomatic tandem lumbar stenosis: A review

Cited by 19 publications

References 26 publications

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

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

Isolated and Combined Degenerative Tandem Cervical and Lumbar Spinal Stenoses: Literature Review

One-staged combined decompression for the patients with cervico-thoracic tandem spinal stenosis

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