One-staged combined cervical and lumbar decompression for patients with tandem spinal stenosis on cervical and lumbar spine: analyses of clinical outcomes with minimum 3 years follow-up

J Spinal Disord Tech. 2009 Dec;22(8):593-601. doi: 10.1097/BSD.0b013e3181929cbd.

Abstract

Study design: Retrospective study of clinical outcomes of 1-staged combined cervical and lumbar decompression for patients with tandem spinal stenosis (TSS).

Objective: To describe middle-term clinical outcomes of this procedure.

Summary and background data: Little is known with regard to the clinical outcomes of 1-staged combined cervical and lumbar decompression for TSS.

Method: Surgical intervention, perioperative complications, and clinical outcomes were reviewed in 17 TSS patients who underwent 1-staged combined cervical and lumbar decompression and were followed-up for more than 3 years. Clinical symptoms were evaluated using the Japan Orthopaedic Association Score for back pain (JOA-B) and cervical myelopathy (JOA-C) and activity of daily life, before surgery, at 6 months postoperatively, and at final follow-up. Patient satisfaction was determined at final follow-up.

Results: The JOA-B, JOA-C scores, and activities of daily life improved significantly 6 months after surgery, but ultimately deteriorated. At 6 months, the improvement ratios in JOA-B and JOA-C scores were positively correlated. Complications involving other parts of the body significantly influenced clinical deterioration. Twelve patients (71%) were satisfied.

Conclusions: One-staged combined cervical and lumbar decompression for TSS provided fair results, even for elderly patients. Although reasons other than spinal pathology affected symptom deterioration at final follow-up, most patients expressed satisfaction at middle-term follow-up periods.

MeSH terms

  • Activities of Daily Living
  • Age Factors
  • Aged
  • Aged, 80 and over
  • Back Pain / etiology
  • Back Pain / physiopathology
  • Back Pain / surgery
  • Cervical Vertebrae / diagnostic imaging
  • Cervical Vertebrae / pathology
  • Cervical Vertebrae / surgery*
  • Decompression, Surgical / methods*
  • Female
  • Follow-Up Studies
  • Humans
  • Lumbar Vertebrae / diagnostic imaging
  • Lumbar Vertebrae / pathology
  • Lumbar Vertebrae / surgery*
  • Male
  • Middle Aged
  • Neck Pain / etiology
  • Neck Pain / physiopathology
  • Neck Pain / surgery
  • Neurosurgical Procedures / methods*
  • Outcome Assessment, Health Care / methods
  • Pain Measurement / methods
  • Patient Satisfaction
  • Postoperative Complications / epidemiology
  • Postoperative Complications / etiology
  • Radiography
  • Recurrence
  • Retrospective Studies
  • Spinal Canal / diagnostic imaging
  • Spinal Canal / pathology
  • Spinal Canal / surgery
  • Spinal Cord Compression / diagnostic imaging
  • Spinal Cord Compression / pathology
  • Spinal Cord Compression / surgery*
  • Spinal Stenosis / diagnostic imaging
  • Spinal Stenosis / pathology
  • Spinal Stenosis / surgery*
  • Treatment Failure
  • Treatment Outcome