颈椎和腰椎并发椎管狭窄症Ⅰ期手术减压的临床疗效

doi:10.13418/j.issn.1001-165x.2015.04.021

Chinese Journal Of Clinical Anatomy ›› 2015, Vol. 33 ›› Issue (4): 468-471.doi: 10.13418/j.issn.1001-165x.2015.04.021

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The anatomic feature and Clinical outcomes of one-staged decompression for patients with combined cervical and lumbar stenosis

SHEN Lian-cheng¹, LONG Hou-qing², XU Jing-hui², HUANG Yang-liang², LI Fo-bao²

1. Department of Orthopedics, Shun De new Rong-qi hospital of Guangdong Province, Guangdong 528303,China; 2. Department of Spine Surgery, the First Affiliated Hospital of Sun Yat-Sen University, Guangzhou 510700, China

Received:2015-03-22 Online:2015-07-25 Published:2015-08-14

Abstract

Abstract:

Objective　To evaluate clinical outcomes and safety of one-staged combined cervical and lumbar decompression for patients with tandem spinal stenosis. 　Methods　Clinical outcomes and perioperative complications were reviewed in 22 patients who underwent one-staged combined cervical and lumbar decompression retrospectively. The mean age was (68.7±9.3) years(55～83 years).The follow-up period ranged from 24 to 58 months. The JOA score and its recovery rate（cervical-17 points, lumbar-29 points）were recorded before operation, 1 month after surgery, and at the final follow-up.　Results　The mean surgical duration, blood loss, and hospitalization length were (189±49) min、(490±70) ml、15.9 days respectively. The JOA recovery rate were 67.9% for cervical and 63.5% for lumbar at the final follow-up. The improvement degree of JOA scores was significant compared with that of pre-operation. The overall complication incidence were 18.1%, which included acute blood loss anemia 1 case, cerebrospinal fluid leakage 1 case, deep infection 1 case, Transient neurological deficiency 1 case.　Conclusions　One-staged combined cervical and lumbar decompression for TSS can deliver fair results. It is a safe and effective method for this condition.

Key words: One-stage decompression, CervicalLumbarTandem spinal stenosis

References

[1] Naderi S, Mertol T. Simultaneous cervical and lumbar surgery for combined symptomatic cervical and lumbar spinal stenoses[J]. J Spinal Disord Tech, 2002,15(3):229-232.
[2] LaBan MM, Green ML. Concurrent (tandem) cervical and lumbar spinal stenosis: a 10-yr review of 54 hospitalized patients[J]. Am J Phys Med Rehabil, 2004, 83(3): 187-190.
[3] 刘志伟, 杨惠林, 张志明，等. 颈腰综合征的诊断及其手术治疗22例分析[J]. 苏州大学学报.医学版，2008，28(1):154-155.
[4] Kikuike K, Miyamoto K, Hosoe H, et al. One-staged combined cervical and lumbar decompression for Patients With Tandem Spinal Stenosis on Cervical and Lumbar Spine[J]. J Spinal Disord Tech, 2009, 22(8): 593-601.
[5] 龙厚清，植山和正，刘少喻，等. 保留C2棘突半棘肌附着的颈椎管扩大椎板成形术[J].中国临床解剖学杂志，2006，24(5):493-497.
[6] Brain R, Wilkinson M. The association of cervical spondylosis and disseminated sclerosis[J]. Brain, 1957, 80(4):456-478.
[7] Molinari RW, Flanigan R, Yaseen Z. Tandem spinal stenosis (TSS): literature review and report of patients treated with simultaneous decompression[J]. Current Orthopaedic Practice, 2012, 23 (4)：356-363.
[8] Bajwa NS, Toy JO, Young EY. Is congenital bony stenosis of the cervical spine associated with lumbar spine stenosis? An anatomical study of 1072 human cadaveric specimens[J]. J Neurosurg Spine, 2012, 17(1):24-29.
[9] Bajwa NS, Toy JO, Young EY. Is lumbar stenosis associated with thoracic stenosis? A study of 1,072 human cadaveric specimens[J]. Spine J, 2012,12 (12): 1142-1146.
[10]Okada E, Matsumoto M, Fujiwara H, et al. Disc degeneration of cervical spine on MRI in patients with lumbar disc herniation: comparison study　with asymptomatic volunteers[J]. Eur Spine J, 2011,20(4):585-591.
[11]Lee M, Garcia R, Cassinelli EH, et al. Tandem stenosis: a cadaveric study in osseous morphology[J]. Spine J, 2008, 8(6): 1003-1006.
[12]Eskander MS, Aubin ME, Drew JM, et al. Is there a difference between simultaneous or staged decompressions for combined cervical and lumbar stenosis[J]? J Spinal Disord Tech, 2011, 24(6):409-413.
[13]Hsieh CH, Huang TJ, Hsu RW. Tandem spinal stenosis: clinical diagnosis and surgical treatment[J]. Changgeng Yi Xue Za Zhi, 1998, 21(4):429-435.
[14]Aydogan M, Ozturk C, Mirzanli C, et al. Treatment approach in tandem (concurrent) cervical and lumbar spinal stenosis[J]. Acta Orthop Belg, 2007, 73(2):234-237.

The anatomic feature and Clinical outcomes of one-staged decompression for patients with combined cervical and lumbar stenosis

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