Tandem Spinal Stenosis at the Brazzaville Academic Hospital

Spinal stenosis in tandem (SST) 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 report the one that was set up on the cases observed at the CHU-B.

A retrospective study of 16 patients operated for SST, from June 2009 to May 2019, was conducted. We analyzed the demographic, clinical, paraclinical, therapeutic and evolutionary data of these patients.

In ten years, 16 patients (9 men and 7 women) with SST had been received. They were on average 57 years (41 and 72 years). The signs evolved for 17.6 months (13 and 30 months) and were made of radicular and / or medullary compression syndrome of cervical, thoracic and / or lumbar localization. Medical imaging made it possible to objectify the cervico-thoracic (1 case), thoraco-lumbar (2 cases) and cervico-lumbar lesions (13 cases). The surgery was performed in one stage in two cases and in 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 cranio-caudal.Signs improved in 13 patients and stabilized in 3 patients.

The combination of lumbo-radicular and medullary signs should search for SST. The surgery indicated after an MRI examination, is performed in one or two stages, following a cranio-caudal order or not. It allows, when it is performed early, a clinical improvement of these patients.