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Cervical Decompression for Tandem Spinal Stenosis: the Impact on Low Back Pain at One-Year Follow-Up Matthew D

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Cervical Decompression for Tandem Spinal Stenosis: the Impact on Low Back Pain at One-Year Follow-Up Matthew D Cervical Decompression for Tandem Spinal Stenosis: The Impact on Low Back Pain at One-Year Follow-Up Matthew D. Alvin MBA, MS, MA; Vincent J Alentado BS; Daniel Lubelski MD; Edward C. Benzel MD; Thomas E. Mroz MD Introduction Results References References, continued 1.Teng P and Papatheodorou C. Combined 8.Parker SL, Godil S, Shau DN, Mendenhall SK, Tandem spinal stenosis (TSS) can Both surgical cohorts showed cervical and lumbar spondylosis. Arch Neurol McGirt MJ. Assessment of the minimum clinically present similarly to cervical significant (p<0.01) pre- to 1964;10:298-308. important difference in pain, disability, and 2.LaBan MM and Green ML. Concurrent quality of life after anterior cervical discectomy spondylotic myelopathy, but often postoperative improvement for VAS (tandem) cervical and lumbar spinal stenosis: a and fusion. J Neurosurg Spine 2013; 18:154- has a worse prognosis. Few studies neck and arm scores at 1-year post- 10-yr review of 54 hospitalized patients. Am J 160. Phys Med Rehabil 2004;83:187-90. 9.Wilson HD. Minimum clinical important have investigated outcomes and op and significantly greater 3.Eskander MS, Aubin ME, Balsis SM, et al. Is differences of health outcomes in a chronic pain compared treatment approaches for improvements than the conservative there a difference between simultaneous or population: Are they predictive of poor staged decompression for combined cervical outcomes? UT Arlington Dissertation 2008. patients with TSS. In the present cohort. In addition, the cohort and lumbar stenosis. J Spinal Disord Tech 10.Epstein WE, Epstein JA, Carras R, et al. study, we sought to determine the undergoing cervical spine surgery 2011;24:409-13. Coexisting lumbar and cervical spinal stenosis” 4.Hsieh CH, Huang TJ, Hsu RW. Tandem spinal diagnosis and management. Neurosurgery impact of cervical spine surgery on alone experienced significant stenosis: clinical diagnosis and surgical 1984;15:489-96. cervical and lumbar spine symptoms improvement in the EQ-5D score treatment. Changgeng Yi Xue Za Zhi 11.Dagi TF, Trakington MA, Leech JJ. Tandem 1998;21:429-35. lumbar and cervical spinal stenosis: natural in patients with symptomatic tandem whereas those undergoing both 5.Kikuike K, Miyamoto K, Hosoe H, Shimizu K. history, prognostic indices, and results after spinal stenosis. cervical and lumbar spine surgery One-staged combined cervical and lumbar surgical decompression. J Neurosurg decompression for patients with tandem spinal 1987;66:842-9. did not. Low back pain remained the stenosis on cervical and lumbar spine: analyses 12.Naderi S and Mertol T. Simultaneous cervical Methods same or worsened for both surgical of clinical outcomes with minimum 3 years and lumbar surgery for combined symptomatic follow-up. J Spinal Disord Tech 2009;22:593- cervical and lumbar spinal stenosis. J Spinal Eighty-four patients with clinical and cohorts at both the initial 601. Disord Tech 2002;15:229-32. imaging evidence of TSS were postoperative visit as well as 6.Langfitt TW and Elliott FA. Pain in the back 13.Aydogan M, Ozturk C, Mirzanli C, et al. and legs caused by cervical spinal cord Treatment approach in tandem (concurrent) identified between 2008 and 2013. through the final follow-up. compression. JAMA 1967;200:382-5. cervical and lumbar spinal stenosis. Acta Orthop Of those identified, 48 underwent 7. Parker SL, McGirt MJ. Determination of the Belg 2007;73:234-7. minimum improvement in pain, disability, and 14.Krishnan A, Dave BR, Kambar AK, Ram H. cervical spine surgery alone, 20 Conclusions health state associated with cost-effectiveness: Coexisting lumbar and cervical stenosis (tandem underwent both cervical and lumbar Cervical spine surgery with or introduction of the concept of minimum cost- spinal stenosis): an infrequent presentation. effective difference. Neurosurgery 2012; Retrospective analysis of single-stage surgery spine surgery, and 16 received without follow-up lumbar spine 71:1149-55. (53 cases). Eur Spine J 2014;23:64-73. 15.Krieg SM and Meyer B. Quest for level I conservative treatment alone surgery significantly improves neck evidence in the treatment of cervical spondylotic (conservative cohort). Quality of life pain in patients with TSS. In Learning Objectives myelopathy. World Neurosurg. 2014;81:501-2. (QOL) measures included the Visual contrast, cervical spine surgery in By the conclusion of this session, 16.Alvin MD, Lubelski D, Benzel EC, Mroz TE. participants should be able to: 1) Ventral fusion versus dorsal fusion: determining Analogue Scale (VAS) for arm, these patients does not improve low the optimal treatment for cervical spondylotic Describe the importance of tandem neck, and back, Pain Disability back pain. Rather, it may unmask myelopathy. Neurosurg Focus. 2013;35:E5. spinal stenosis and when it should be Questionnaire (PDQ), Patient Health lumbar symptoms leading to considered as a diagnosis, 2) Discuss, Questionnaire-9 (PHQ-9), and subsequent lumbar spine surgery. In in small groups, what treatment is the EuroQOL-5 Dimensions (EQ-5D) our cohort of TSS patients, lumbar most appropriate relative to outcome, and were acquired at baseline (pre- surgery also did not improve low and 3) Identify reasons why [Default Poster] decompression of one area of the operative), and 1 year back pain or quality of life. Future spine may help resolve or worsen postoperatively. prospective studies are necessary to symptoms in the other area of the confirm these findings and examine spine. the impact of lumbar decompression alone on cervical spine symptoms in patients with TSS..
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