Tandem Spinal Stenosis at the Brazzaville Academic Hospital

Background and Aim: Tandem Spinal Stenosis (TSS) can be defined as simultaneous stenosis of two distinct spinal (cervical, thoracic and lumbar) areas. Characterized by an association of the spinal, radicular and medullary signs of the limbs, the planning of his surgery remains controversial. We reported the one that was set up on the cases observed at the Brazzaville Academic Hospital.  Methods and Materials/Patients: A retrospective study of 16 patients operated for TSS, from June 2009 to May 2019, was conducted. We analyzed the demographic, clinical, paraclinical, therapeutic and evolutionary data of these patients. Results: For ten years, a total of 16 patients (9 men and 7 women) with SST have been received. The average age was 57 years (ranged 41-72 years). The signs evolved for 17.6 months (13 and 30 months). These were lombo-sciatalgias in 15 cases, signs of medullary compression: cervical in 14 cases and thoracic in 2 cases. Medical imaging had objective 13 cervico-lumbar associations, two thoraco-lumbar associations and one cervico-thoracic. The surgery was performed in one stage in two cases and two stages in 14 cases. These were laminectomies for lumbar and thoracic disorders, discectomy or somatotomy in the cervical segment. The order of surgical management was cervico-thoraco-lumbar (cranio- caudal order). Signs improved in 13 patients and stabilized in 3 patients. Conclusion: TSS is not uncommon. It should be researched in a patient with bifocal spinal and radiculo-medullary signs. Their early surgical treatment, in one or two stages, yields satisfactory results.

Keywords:

Tandem Spinal Stenosis (TSS) , Simultaneous cervico-lumbar stenosis , Simultaneous thoraco-lumbar stenosis , Simultaneous cervico-thoracic stenosis , Spine surgery