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TANDEM SPINAL STENOSIS: DILEMMA IN DIAGNOSIS AND MANAGEMENT

TANDEM SPINAL STENOSIS: DILEMMA IN DIAGNOSIS AND MANAGEMENT. Selhan KARADERELER, MD Kursat GANIYUSUFOGLU, MD Levent ULUSOY, MD Cagatay OZTURK, MD Ahmet ALANAY, MD Azmi HAMZAOGLU, MD Istanbul Spine Center Florence Nightingale Hospital Istanbul-TURKEY. INTRODUCTION.

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TANDEM SPINAL STENOSIS: DILEMMA IN DIAGNOSIS AND MANAGEMENT

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  1. TANDEM SPINAL STENOSIS: DILEMMA IN DIAGNOSIS AND MANAGEMENT Selhan KARADERELER, MD Kursat GANIYUSUFOGLU, MD Levent ULUSOY, MD Cagatay OZTURK, MD Ahmet ALANAY, MD Azmi HAMZAOGLU, MD Istanbul Spine Center Florence Nightingale Hospital Istanbul-TURKEY

  2. INTRODUCTION • Spondylotic degeneration can manifest as tandem (concurrent) cervical, thoracic and/or 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.

  3. PURPOSE • To report the existence and management of tandem (concurrent) cervical, thoracic and/or lumbar spinal stenosis. • Between the years 2002 – 2008 • 49 patients (34 women and 15 men) with tandem spinal stenosis of at least two locations of 3 regions of the spine in a series of 758 patients who underwent surgery for spinal stenosis (a frequency of 6.4 %). PATIENT SAMPLE

  4. METHODS • Themeanage 67 years (51-80). • Inthisgroup of patients, a stagedsurgeryforcervical, thoracicandlumbarspinalstenosiswasperformed. • Theclinicalresultswereevaluatedaccordingto • JapaneseOrthopedicAssociation (JOA) scoreforcervicalandthoracicstenosis • OswestryDisabilityScoreforlumbarstenosis.

  5. RESULTS • Themeanfollow-upperiod 51.4 (24-96) m • Therewasconcurrentspinalstenosis of • cervicalandlumbarspine 38 patients • cervicalandthoracicspine 2 patients • thoracicandlumbarspine 5 patients • cervical, thoracicandlumbarspine 4 patients.

  6. RESULTS • OswestryDisabilityScore • 58.1 preoperatively • 29 in discharge • 19.3 at latestfollow-up. • The JOA score 8.1 preoperatively 11.8 in discharge 12.7 at final follow-up.

  7. RESULTS • Therewere no infections in patients. • Intraoperativeandpostoperativecomplicationsincluded • onedeath • one dural tear • onelatedeepvenousthrombosis. • Allpatients had significantimprovement in myelopathyandwereambulatory at the final follow-up.

  8. CONCLUSION • Although tandem spinal stenosis occurred relatively infrequent, its potential presence should not be overlooked. • A remarkable incidence of thoracic stenosis (22% of all tandem cases) has been observed and the diagnosis might be difficult especially in patients with concurrent cervical stenosis.

  9. THANK YOU

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