A Survey of Tandem Spinal Stenosis in Shiraz, Southern Iran

Abstract

Background: Symptomatic tandem spinal stenosis is characterized by the triad of intermittent neurogenic claudication, progressive gait disturbance, and findings of mixed myelopathy and polyradiculopathy in both the upper and lower extremities. This study was conducted to evaluate tandem spinal stenosis in Shiraz, Southern Iran, by finding the co-occurrence of lumbar spinal stenosis in patients with documented cervical stenosis. Methods: During the last 5 years, all patients attending hospitals affiliated to Shiraz University of Medical Sciences in Southern Iran with proven cervical spinal canal stenosis were enrolled. Spinal canal stenosis was documented by myelography and/or magnetic resonance imaging. Results: Seventy patients (mean of 62 y for men and 53 y for women) had cervical canal stenosis with 24 coexistent lumbar canal stenosis cases. Thirty-four percent of patients with cervical spinal stenosis had lumbar spinal stenosis. The clinical presentations involved a classic neurogenic claudication, a complex gait disturbance, and a mixed pattern of diffuse upper and lower motor neuron disturbances. Conclusions: As the incidence of asymptomatic cervical or thoracic lesions is high in elderly patients, a preoperative evaluation of the cervical and thoracic spine in these patients seems necessary and its potential presence should not be overlooked, and the presence of tandem cervical and thoracic stenosis seems to be partly correlated with the tandem presence of a congenitally small cervical and thoracic canal.