Results of staged surgical treatment of patients with tandem stenosis of the cervical and lumbosacral spine

Abstract

Objective. To conduct a retrospective analysis of staged surgery in patients with tandem stenosis of the cervical and lumbosacral spine, to iden- tify causes of poor outcomes. Material and Methods. The study included 190 patients with tandem stenosis of the cervical and lumbosacral spine. Out of them 72 had symp- tomatic cervical and asymptomatic lumbosacral tandem stenosis (Group 1), 67 – symptomatic lumbar and asymptomatic cervical tandem ste- nosis (Group 2), and 51 – compression with neurological manifestations in both spine departments (Group 3). Patient’s anthropometric data, initial clinical symptoms, and duration of disease were analyzed. The intraoperative characteristics of surgical interventions and features of the postoperative period, clinical parameters and the existence of complications were evaluated. Results. Excellent and good postoperative outcomes were achieved in patients of Groups 1 and 2 with monosymptomatic tandem stenosis, in patients of Group 3 with symptomatic tandem stenosis, and in patients of all groups who underwent laminectomy and bilateral foraminotomy for bilateral symptomatic foraminal stenosis, and minimally invasive bilateral foraminotomy through unilateral approach in case of radiographic evidence of foraminal stenosis without symptoms. Conclusion. Symptomatic tandem stenosis of the cervical and lumbosacral spine is a severe nosological entity requiring meticulous removal of pathological substrate primarily in the cervical spine. The early implementation of the second stage of surgery significantly reduces neurological symptoms, relieves pain and improves quality of life in patients.

Keywords

• tandem spinal stenosis
• diagnosis
• surgical treatment