• Eur Spine J · Mar 2022

    Review Meta Analysis

    Simultaneous decompression of all stenotic regions versus decompression of only the most symptomatic region in patients with tandem spinal stenosis: a systematic review and meta-analysis.

    • Samarth Mittal, Kaustubh Ahuja, P V Sudhakar, Syed Ifthekar, Gagandeep Yadav, Bhaskar Sarkar, and Pankaj Kandwal.
    • AIIMS Rishikesh, Rishikesh, Uttarakhand, 249203, India.
    • Eur Spine J. 2022 Mar 1; 31 (3): 561-574.

    PurposeSelection of anatomic region of spine for decompression in patients with symptomatic tandem spinal stenosis (TSS) remains a challenge due to the confusing clinical presentation as well as uncertain evidence. A systematic review and meta-analysis of observational studies were conducted to compare the outcomes between simultaneous decompression of all stenotic regions (cervical and lumbar, Group 1) and decompression of only the most symptomatic stenotic region (cervical/lumbar, Group 2) in patients with TSS.MethodsA systematic review was conducted, and a comprehensive literature search with well-established inclusion and exclusion criteria with JOA score as an outcome measure was done on PubMed, Google Scholar, and EMBASE database (till January 2021). Observational studies reporting outcomes after simultaneous decompression or only the most symptomatic region were included. NIH quality assessment tool was used to check the quality of each study, and treatment effects were calculated using Dersimonian and Laird random effects model.ResultsTen studies were included in the analysis out of which all were retrospective observational studies (Level 4 evidence) except one (Level 3 evidence). Overall proportional meta-analysis showed no significant difference in change in JOA scores, operative time, blood loss, total and major complications between Group 1 and Group 2. However, minor complications were significantly increased on performing decompression of both regions simultaneously (p = 0.04). On performing subgroup analysis comparing cervical surgery cohort with lumbar surgery cohort, no difference was found in change in JOA score and requirement of second-stage surgery.ConclusionDecompression of the most symptomatic region alone irrespective of its location has equal clinical outcomes with less complication rate than simultaneous decompression in patients with TSS.© 2021. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.

      Pubmed     Full text   Copy Citation     Plaintext  

      Add institutional full text...

    Notes

     
    Knowledge, pearl, summary or comment to share?
    300 characters remaining
    help        
    You can also include formatting, links, images and footnotes in your notes
    • Simple formatting can be added to notes, such as *italics*, _underline_ or **bold**.
    • Superscript can be denoted by <sup>text</sup> and subscript <sub>text</sub>.
    • Numbered or bulleted lists can be created using either numbered lines 1. 2. 3., hyphens - or asterisks *.
    • Links can be included with: [my link to pubmed](http://pubmed.com)
    • Images can be included with: ![alt text](https://bestmedicaljournal.com/study_graph.jpg "Image Title Text")
    • For footnotes use [^1](This is a footnote.) inline.
    • Or use an inline reference [^1] to refer to a longer footnote elseweher in the document [^1]: This is a long footnote..

    hide…