239. Prospective analysis of functional outcome of single stage surgical treatment for symptomatic tandem spinal stenosis

Abstract

BACKGROUND CONTEXT Tandem spinal stenosis (TSS) is a rare presentation leading to combined clinical features of upper motor neuron and lower motor neuron lesion which includes intermittent neurogenic claudication with or without neurological deficit, progressive gait imbalance and gait disturbances. Such presentation was usually treated with staged surgery in past and few studies have reported single stage surgical intervention. PURPOSE To discuss safety, efficacy and evaluate the outcome of single stage surgical intervention for TSS. STUDY DESIGN/SETTING A total of 82 patients with TSS were prospectively analysed in our study for clinical and functional outcome after single stage surgical intervention. PATIENT SAMPLE From June 2009 to November 2016 in a series of 1,381 patients who underwent surgery for various degenerative spinal conditions, 82 patients were diagnosed as having symptomatic OUTCOME MEASURES All patients were evaluated pre- and postoperatively at each follow-up with mJOA score, Nurick's grading, Oswestry Disability index (ODI) and Cooper scale. METHODS From June 2009 to November 2016 in a series of 1,381 patients who underwent surgery for various degenerative spinal conditions, 82 patients were diagnosed as having symptomatic TSS with an incidence of 5.93 %. All patients diagnosed with TSS underwent single stage surgical intervention by one surgical team. The peri-operative factors were recorded for each patient. All patients were evaluated pre- and postoperatively at each follow-up with mJOA score, Nurick's grading, ODI and Cooper scale. RESULTS In our study 82 patients including 70 males and 12 females underwent simultaneous surgical intervention for symptomatic TSS. The mean age of patients was 61.78 ± 10.48 years. There was significant improvement in mJOA score, nuricks grading, ODI and Coopers scale post-operatively as compared to preoperative values (p value CONCLUSIONS Symptomatic TSS can be safely managed by single stage surgical intervention with good post-operative results and without significant increase in complication rates. This helps in reducing the cost for hospitalisation, avoid need for repeated intubation as well as reducing patients morbidity by avoiding the need for second surgical procedure. FDA DEVICE/DRUG STATUS This abstract does not discuss or include any applicable devices or drugs.