A retrospective comparison of simultaneous and staged surgery for degenerative cervico-lumbar tandem spinal stenosis
Background: Cervical and lumbar tandem spinal stenosis (CLTSS) is a major cause of morbidity secondary to compressive degeneration of the spine. Currently, there is a paucity of studies objectively addressing the best management for this condition in terms of efficacy and cost-effectiveness. Hence,...
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| Format: | Article |
| Language: | English |
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Elsevier
2023-12-01
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| Series: | Interdisciplinary Neurosurgery |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2214751923001068 |
| _version_ | 1797776656913399808 |
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| author | Parménides Guadarrama-Ortiz César Osvaldo Ruíz-Rivero Deyanira Capi-Casillas Ingrid Montes de Oca-Vargas André Garibay-Gracián Jesús David Peña-Bartolone Alondra Román-Villagómez Ulises Palacios-Zúñiga Ángel Daniel Prieto-Rivera José Alberto Choreño-Parra |
| author_facet | Parménides Guadarrama-Ortiz César Osvaldo Ruíz-Rivero Deyanira Capi-Casillas Ingrid Montes de Oca-Vargas André Garibay-Gracián Jesús David Peña-Bartolone Alondra Román-Villagómez Ulises Palacios-Zúñiga Ángel Daniel Prieto-Rivera José Alberto Choreño-Parra |
| author_sort | Parménides Guadarrama-Ortiz |
| collection | DOAJ |
| description | Background: Cervical and lumbar tandem spinal stenosis (CLTSS) is a major cause of morbidity secondary to compressive degeneration of the spine. Currently, there is a paucity of studies objectively addressing the best management for this condition in terms of efficacy and cost-effectiveness. Hence, we aimed to conduct a side-by-side retrospective analysis of surgical outcomes, clinical improvement, and cost of care in non-Caucasian Hispanic patients with moderate-to-severe CLTSS subjected to simultaneous or staged cervical and lumbar spine surgery. Methods: Retrospective review of clinical records and postoperative outcomes of adult patients subjected to cervical and lumbar spine surgery either simultaneously or in stages. The surgical pattern was selected based on clinical studies, physical examination, and radiological findings, with monthly follow-up through objective clinical scores for at least six months after the last surgery. Results: Twelve patients received simultaneous cervical and lumbar spine surgery and six staged operations, both groups with comparable baseline comorbidities, manifestations, radiological findings, and receiving similar surgical procedures and postoperative management. Anterior cervical discectomy and fusion and transforaminal lumbar interbody fusion were the standard procedures performed in the cohort. Three patients in the staged-operation group received cervical decompression first. There were no differences between the groups' surgical outcomes, functional recovery, and complication rates. Nonetheless, the total cost of care was significantly lower in patients receiving simultaneous operation, while the clinical improvement was equivalent in both groups. Conclusions: Simultaneous and staged decompression offer similar outcomes for patients with CLTSS, but the one-staged combined surgery has a better cost- effectiveness profile. |
| first_indexed | 2024-03-12T22:53:03Z |
| format | Article |
| id | doaj.art-70c3d2819ec048e69970092958548260 |
| institution | Directory Open Access Journal |
| issn | 2214-7519 |
| language | English |
| last_indexed | 2024-03-12T22:53:03Z |
| publishDate | 2023-12-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Interdisciplinary Neurosurgery |
| spelling | doaj.art-70c3d2819ec048e699700929585482602023-07-20T04:38:41ZengElsevierInterdisciplinary Neurosurgery2214-75192023-12-0134101823A retrospective comparison of simultaneous and staged surgery for degenerative cervico-lumbar tandem spinal stenosisParménides Guadarrama-Ortiz0César Osvaldo Ruíz-Rivero1Deyanira Capi-Casillas2Ingrid Montes de Oca-Vargas3André Garibay-Gracián4Jesús David Peña-Bartolone5Alondra Román-Villagómez6Ulises Palacios-Zúñiga7Ángel Daniel Prieto-Rivera8José Alberto Choreño-Parra9Department of Neurosurgery, Centro Especializado en Neurocirugía y Neurociencias México, Mexico City, Mexico; Corresponding author at: Department of Neurosurgery, Centro Especializado en Neurocirugía y Neurociencias México, Mexico City, Mexico.Department of Neurosurgery, Centro Especializado en Neurocirugía y Neurociencias México, Mexico City, MexicoDepartment of Neurosurgery, Centro Especializado en Neurocirugía y Neurociencias México, Mexico City, MexicoDepartment of Neurosurgery, Centro Especializado en Neurocirugía y Neurociencias México, Mexico City, MexicoDepartment of Neurosurgery, Centro Especializado en Neurocirugía y Neurociencias México, Mexico City, MexicoDepartment of Neurosurgery, Centro Especializado en Neurocirugía y Neurociencias México, Mexico City, Mexico; Department of Spine Surgery, Hospital Regional ISSSTE Monterrey, Nuevo León, MexicoDepartment of Neurosurgery, Centro Especializado en Neurocirugía y Neurociencias México, Mexico City, MexicoDepartment of Neurosurgery, Spine Surgery Service, Hospital Regional 1° de Octubre, ISSSTE, Mexico City, MexicoDepartment of Neurosurgery, Centro Especializado en Neurocirugía y Neurociencias México, Mexico City, MexicoDepartment of Clinical Research, Centro Especializado en Neurocirugía y Neurociencias México, Mexico City, MexicoBackground: Cervical and lumbar tandem spinal stenosis (CLTSS) is a major cause of morbidity secondary to compressive degeneration of the spine. Currently, there is a paucity of studies objectively addressing the best management for this condition in terms of efficacy and cost-effectiveness. Hence, we aimed to conduct a side-by-side retrospective analysis of surgical outcomes, clinical improvement, and cost of care in non-Caucasian Hispanic patients with moderate-to-severe CLTSS subjected to simultaneous or staged cervical and lumbar spine surgery. Methods: Retrospective review of clinical records and postoperative outcomes of adult patients subjected to cervical and lumbar spine surgery either simultaneously or in stages. The surgical pattern was selected based on clinical studies, physical examination, and radiological findings, with monthly follow-up through objective clinical scores for at least six months after the last surgery. Results: Twelve patients received simultaneous cervical and lumbar spine surgery and six staged operations, both groups with comparable baseline comorbidities, manifestations, radiological findings, and receiving similar surgical procedures and postoperative management. Anterior cervical discectomy and fusion and transforaminal lumbar interbody fusion were the standard procedures performed in the cohort. Three patients in the staged-operation group received cervical decompression first. There were no differences between the groups' surgical outcomes, functional recovery, and complication rates. Nonetheless, the total cost of care was significantly lower in patients receiving simultaneous operation, while the clinical improvement was equivalent in both groups. Conclusions: Simultaneous and staged decompression offer similar outcomes for patients with CLTSS, but the one-staged combined surgery has a better cost- effectiveness profile.http://www.sciencedirect.com/science/article/pii/S2214751923001068Tandem spinal stenosisSpine surgerySurgical outcomesCost-effectiveness |
| spellingShingle | Parménides Guadarrama-Ortiz César Osvaldo Ruíz-Rivero Deyanira Capi-Casillas Ingrid Montes de Oca-Vargas André Garibay-Gracián Jesús David Peña-Bartolone Alondra Román-Villagómez Ulises Palacios-Zúñiga Ángel Daniel Prieto-Rivera José Alberto Choreño-Parra A retrospective comparison of simultaneous and staged surgery for degenerative cervico-lumbar tandem spinal stenosis Interdisciplinary Neurosurgery Tandem spinal stenosis Spine surgery Surgical outcomes Cost-effectiveness |
| title | A retrospective comparison of simultaneous and staged surgery for degenerative cervico-lumbar tandem spinal stenosis |
| title_full | A retrospective comparison of simultaneous and staged surgery for degenerative cervico-lumbar tandem spinal stenosis |
| title_fullStr | A retrospective comparison of simultaneous and staged surgery for degenerative cervico-lumbar tandem spinal stenosis |
| title_full_unstemmed | A retrospective comparison of simultaneous and staged surgery for degenerative cervico-lumbar tandem spinal stenosis |
| title_short | A retrospective comparison of simultaneous and staged surgery for degenerative cervico-lumbar tandem spinal stenosis |
| title_sort | retrospective comparison of simultaneous and staged surgery for degenerative cervico lumbar tandem spinal stenosis |
| topic | Tandem spinal stenosis Spine surgery Surgical outcomes Cost-effectiveness |
| url | http://www.sciencedirect.com/science/article/pii/S2214751923001068 |
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