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Evaluation and Treatment of Tandem Spinal Stenosis

Baker, Joseph F. MCh, FRCSI

Journal of the American Academy of Orthopaedic Surgeons: October 24, 2019 - Volume Publish Ahead of Print - Issue - p
doi: 10.5435/JAAOS-D-18-00726
Review Article: PDF Only

Tandem spinal stenosis (TSS) refers to simultaneous narrowing of noncontiguous regions of the spinal canal, typically the cervical and lumbar region. Symptomatic TSS may be present in more than 10% of patients presenting with spinal symptoms secondary to stenosis in any one region. Clinical presentation may present challenges because of a mixture of upper and lower motor neuron lesions that can confuse and mislead the clinician. Stenosis at another level may only be detected late, when there is failure to improve after treatment, and, if not detected, can result in either poor treatment outcomes or catastrophic complications. There is no uniform agreement in the management of TSS, and the reported surgical strategies include both simultaneous and staged approaches with each having positive and negative features. This article aims to provide the reader with details on the prevalence, evaluation, and guidance in treatment strategy for TSS.

From the Department of Surgery, University of Auckland, Auckland, Zealand, the Department of Orthopaedic Surgery, Waikato Hospital, and Waikato Institute of Surgical Education and Research, Hamilton, New Zealand.

Neither Mr. Baker nor any immediate family member has received anything of value from or has stock or stock options held in a commercial company or institution related directly or indirectly to the subject of this article.

© 2019 by American Academy of Orthopaedic Surgeons
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