Poster 75: Concurrent (tandem) cervical and lumbar spinal stenosis: a 10-year review of 54 hospitalized patients

Abstract

Objective: To determine the prevalence of simultaneous cervical and lumbar spinal stenosis, that is, tandem spinal stenosis based on a 10-year review of hospital admissions. Design: A retrospective study of 460,964 hospital admissions. Setting: A 940-bed academic community hospital. Participants: A base population of 54 patients with tandem spinal stenosis. Intervention: Not applicable. Main Outcome Measures: Patients presented with multiple complaints including, among others, neurogenic claudication, progressive gait disturbances, as well as neurologic signs of both upper- and lower-motoneuron dysfunction. Since 1964, when tandem spinal stenosis was first described, estimates as to its prevalence have varied widely from a low of 5% to a high of 28%. Results: 54 (.012%) cases of tandem spinal stenosis were identified in 460,964 patient admissions during a 10-year period. Of this number, 36 (66.7%) were men and 18 (33.3%) were women. 51 (94.4%) were older than 51 years of age. For all ages, the incidence rate of tandem spinal stenosis in this series was 12 per 100,000. Conclusion: With tandem spinal stenosis the symptoms of either the cervical and/or the lumbar clinical complaints are usually preeminent. Only after the primary pathology is treated does the secondary problem become evident, that is, a decompressive lumbar laminectomy unmasks Babinski reflexes as the first clinical sign of a previously occult cervical spinal stenosis. Although significant tandem spinal stenosis occurs relatively infrequently, in this series (>1%) its potential for interfering with patient recovery should not be overlooked.