Tandem spinal stenosis: clinical diagnosis and surgical treatment.

Chin-Hsiung Hsieh, Tsung-Jen Huang, Robert Wen Wei Hsu

Research output: Chapter in Book/Report/Conference proceedingChapter

25 Citations (Scopus)

Abstract

BACKGROUND: Tandem spinal stenosis (TSS) is defined as spinal stenosis that combines cervical and lumbar spinal stenosis. The primary manifestations include intermittent neurological claudication, progressive gait disturbance, and mixed symptoms and signs of the upper and lower extremities. MATERIALS AND METHODS: From April 1994 through September 1995 in a series of 158 patients who underwent surgery for spinal stenotic syndrome, 12 patients were diagnosed with TSS, with an overall incidence of 7.6%. Our management guidelines required that cervical surgery be performed first if the patients had signs in the upper motor neuron region or predominant signs in the upper extremities. In the patients who had significant symptoms in the lower extremities and no signs in the upper motor neuron region, lumbar surgery was performed first. RESULTS: In this series, 8 of 12 patients received cervical surgery first and 4 required further lumbar surgery. Among the 8 patients who received cervical surgery, 2 received Hirabayashi's laminoplasty, 3 laminectomy, and 3 anterior decompression and fusions. The other 4 patients received lumbar surgery only. The average follow-up period was 32 months (range, 24-40 months). At the latest examinations, 8 patients (66.7%) had excellent or good clinical results. CONCLUSION: Our results revealed that when correct diagnosis and management for patients with TSS was given, the patients usually had satisfactory outcomes. Ossification of the posterior longitudinal ligament (OPLL) was noted in 7 of 12 patients (58.3%) in this study. Thus, OPLL might be a predominant factor in TSS, and larger populations studies are needed to confirm this finding.

Original languageEnglish
Title of host publicationChanggeng yi xue za zhi / Changgeng ji nian yi yuan = Chang Gung medical journal / Chang Gung Memorial Hospital
Pages429-435
Number of pages7
Volume21
Edition4
Publication statusPublished - 1998
Externally publishedYes

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Spinal Stenosis
Ossification of Posterior Longitudinal Ligament
Therapeutics
Motor Neurons
Lower Extremity
Lumbosacral Region
Intermittent Claudication
Laminectomy
Decompression
Gait
Upper Extremity
Signs and Symptoms
Guidelines

Cite this

Hsieh, C-H., Huang, T-J., & Hsu, R. W. W. (1998). Tandem spinal stenosis: clinical diagnosis and surgical treatment. In Changgeng yi xue za zhi / Changgeng ji nian yi yuan = Chang Gung medical journal / Chang Gung Memorial Hospital (4 ed., Vol. 21, pp. 429-435)

Tandem spinal stenosis : clinical diagnosis and surgical treatment. / Hsieh, Chin-Hsiung; Huang, Tsung-Jen; Hsu, Robert Wen Wei.

Changgeng yi xue za zhi / Changgeng ji nian yi yuan = Chang Gung medical journal / Chang Gung Memorial Hospital. Vol. 21 4. ed. 1998. p. 429-435.

Research output: Chapter in Book/Report/Conference proceedingChapter

Hsieh, C-H, Huang, T-J & Hsu, RWW 1998, Tandem spinal stenosis: clinical diagnosis and surgical treatment. in Changgeng yi xue za zhi / Changgeng ji nian yi yuan = Chang Gung medical journal / Chang Gung Memorial Hospital. 4 edn, vol. 21, pp. 429-435.
Hsieh C-H, Huang T-J, Hsu RWW. Tandem spinal stenosis: clinical diagnosis and surgical treatment. In Changgeng yi xue za zhi / Changgeng ji nian yi yuan = Chang Gung medical journal / Chang Gung Memorial Hospital. 4 ed. Vol. 21. 1998. p. 429-435
Hsieh, Chin-Hsiung ; Huang, Tsung-Jen ; Hsu, Robert Wen Wei. / Tandem spinal stenosis : clinical diagnosis and surgical treatment. Changgeng yi xue za zhi / Changgeng ji nian yi yuan = Chang Gung medical journal / Chang Gung Memorial Hospital. Vol. 21 4. ed. 1998. pp. 429-435
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