Aydogan Mehmet, Ozturk Cagatay, Mirzanli Cuneyt, Karatoprak Omer, Tezer Mehmet, Hamzaoglu Azmi
Istanbul Spine Center, Florence Nightingale Hospital, Istanbul, Turkey.
Acta Orthop Belg. 2007 Apr;73(2):234-7.
Spondylotic degeneration can manifest as tandem (concurrent) cervical and lumbar spinal stenosis. The primary manifestations include neurogenic claudication, gait disturbance and a mixture of findings of myelopathy and polyradiculopathy in both the upper and lower extremities. The purpose of this retrospective study was to report the existence and management of tandem (concurrent) cervical and lumbar spinal stenosis. Between 1998 and 2004, 8 patients (6 women and 2 men) were diagnosed with tandem spinal stenosis in a series of 230 patients who underwent surgery for spinal stenosis (3.4%). Three patients received cervical surgery first and 5 patients lumbar surgery first. The Japanese Orthopaedic Association Score of all patients improved from an average of 8.1 preoperatively to an average of 11.8 points at discharge and maintained an average of 12.7 points at final follow-up. Oswestry Disability Score improved from mean 58.1 to 29 at discharge and 19.3 at latest follow-up. All the patients had excellent or good results and none deteriorated neurologically. Although tandem spinal stenosis occurred relatively infrequently, we concluded that its possible presence should not be overlooked. The treatment plan must be designed according to the chief complaints and symptoms of the patient.
脊柱退变可表现为串联性（同时存在）颈椎和腰椎管狭窄。主要表现包括神经源性间歇性跛行、步态障碍以及上肢和下肢脊髓病与多神经根病的混合表现。这项回顾性研究的目的是报告串联性（同时存在）颈椎和腰椎管狭窄的存在情况及治疗方法。在1998年至2004年期间，在230例行椎管狭窄手术的患者中，有8例（6名女性和2名男性）被诊断为串联性椎管狭窄（3.4%）。3例患者先接受颈椎手术，5例患者先接受腰椎手术。所有患者的日本骨科协会评分从术前平均8.1分提高到出院时平均11.8分，末次随访时平均维持在12.7分。Oswestry功能障碍指数评分从出院时的平均58.1分改善至29分，最新随访时为19.3分。所有患者均取得优良效果，且无神经功能恶化情况。尽管串联性椎管狭窄相对少见，但我们得出结论，其可能存在不应被忽视。治疗方案必须根据患者的主要诉求和症状来制定。
