Keiji Nagata1, Noriko Yoshimura2, Hiroshi Hashizume3, Yuyu Ishimoto1, Shigeyuki Muraki2, Hiroshi Yamada1, Hiroyuki Oka4, Hiroshi Kawaguchi5, Toru Akune6, Sakae Tanaka7, Kozo Nakamura6, Munehito Yoshida1. 1. Department of Orthopaedic Surgery, Wakayama Medical University, 811-1 Kimidera, Wakayama, Wakayama, 641-8509, Japan. 2. Department of Joint Disease Research, Faculty of Medicine, 22nd Century Medical and Research Center, The University of Tokyo, Tokyo, Japan. 3. Department of Orthopaedic Surgery, Wakayama Medical University, 811-1 Kimidera, Wakayama, Wakayama, 641-8509, Japan. hashizum@wakayama-med.ac.jp. 4. Department of Medical Research and Management for Musculoskeletal Pain, 22nd Century Medical and Research Center, Faculty of Medicine, The University of Tokyo, Tokyo, Japan. 5. Japan Community Healthcare Organization Tokyo Shinjuku Medical Center, Tokyo, Japan. 6. Rehabilitation Services Bureau, National Rehabilitation Center for Persons with Disabilities, Tokorozawa, Saitama, Japan. 7. Department of Orthopaedic Surgery, Faculty of Medicine, The University of Tokyo, Tokyo, Japan.
Abstract
PURPOSE: Tandem spinal stenosis (TSS) is a condition of combined spinal stenosis in the cervical and lumbar regions. The purpose of this study was to determine the prevalence of radiographic TSS and its association with developmental canal stenosis (DCS). The second purpose was to investigate the extent to which radiographic TSS is associated with cervical myelopathy and symptomatic LSS. METHODS: We recruited 1011 (336 men and 675 women) participants in this population-based study. After excluding those with a pacemaker, a history of cervical or lumbar surgery, disqualification, the MRI data of whole spine was analysed in 931 (mean, 67.3 years) participants. Cervical cord compression (CCC) and radiographic lumbar spinal stenosis (LSS) were evaluated by MRI. The canal-to-body ratio was also measured by plain X-ray. DCS was diagnosed as canal-to-body ratio <0.75. The diagnosis of cervical myelopathy and symptomatic LSS was made by presentation of both symptoms and radiographic compression using MRI. RESULTS: The prevalence of CCC was 24.7%, that of radiographic LSS was 30.2%, and that of radiographic TSS was 11.0% (men, 14.1%; women, 9.4%). The prevalence of TSS was significantly higher in the DCS group than in the non-DCS group (p < 0.001). Among the participants with radiographic TSS, the prevalence of cervical myelopathy and symptomatic LSS was 9.8 and 18.6%, respectively. The coexisting cervical myelopathy and symptomatic LSS was 6.1% in the participants with LSS. CONCLUSIONS: The present study is the first population-based study to clarify TSS characteristic using whole-spine MRI.
PURPOSE: Tandem spinal stenosis (TSS) is a condition of combined spinal stenosis in the cervical and lumbar regions. The purpose of this study was to determine the prevalence of radiographic TSS and its association with developmental canal stenosis (DCS). The second purpose was to investigate the extent to which radiographic TSS is associated with cervical myelopathy and symptomatic LSS. METHODS: We recruited 1011 (336 men and 675 women) participants in this population-based study. After excluding those with a pacemaker, a history of cervical or lumbar surgery, disqualification, the MRI data of whole spine was analysed in 931 (mean, 67.3 years) participants. Cervical cord compression (CCC) and radiographic lumbar spinal stenosis (LSS) were evaluated by MRI. The canal-to-body ratio was also measured by plain X-ray. DCS was diagnosed as canal-to-body ratio <0.75. The diagnosis of cervical myelopathy and symptomatic LSS was made by presentation of both symptoms and radiographic compression using MRI. RESULTS: The prevalence of CCC was 24.7%, that of radiographic LSS was 30.2%, and that of radiographic TSS was 11.0% (men, 14.1%; women, 9.4%). The prevalence of TSS was significantly higher in the DCS group than in the non-DCS group (p < 0.001). Among the participants with radiographic TSS, the prevalence of cervical myelopathy and symptomatic LSS was 9.8 and 18.6%, respectively. The coexisting cervical myelopathy and symptomatic LSS was 6.1% in the participants with LSS. CONCLUSIONS: The present study is the first population-based study to clarify TSS characteristic using whole-spine MRI.
Authors: Y Ishimoto; N Yoshimura; S Muraki; H Yamada; K Nagata; H Hashizume; N Takiguchi; A Minamide; H Oka; H Kawaguchi; K Nakamura; T Akune; M Yoshida Journal: Osteoarthritis Cartilage Date: 2013-03-05 Impact factor: 6.576
Authors: George M Ghobrial; Mark E Oppenlander; Christopher M Maulucci; Matthew Viereck; Srinivas Prasad; Ashwini D Sharan; James S Harrop Journal: Clin Neurol Neurosurg Date: 2014-07-02 Impact factor: 1.876