Management of asymptomatic cervical spinal stenosis in the setting of symptomatic tandem lumbar stenosis: A review

• Published in: Clinical neurology and neurosurgery 2014-09, Vol.124, p.114-118
• Main Authors: Ghobrial, George M, Oppenlander, Mark E, Maulucci, Christopher M, Viereck, Matthew, Prasad, Srinivas, Sharan, Ashwini D, Harrop, James S
• Format: Article
• Language: English
• Subjects: Age; Asymptomatic stenosis; Cervical Vertebrae - pathology; Disease; Humans; Incidental Findings; Lumbar Vertebrae - pathology; Myelopathy; Neurology; Neurosurgery; Patients; Software packages; Spinal cord; Spinal Stenosis - diagnosis; Spinal Stenosis - therapy; Spondylosis; Studies; Surgery
• ISSN: 0303-8467; 1872-6968
• DOI: 10.1016/j.clineuro.2014.06.012

Highlights • Often, asymptomatic cervical stenosis is encountered in the clinical setting during the workup of a symptomatic lumbar stenosis and degenerative disease. • The goal of surgical treatment for CSM is to halt the steady progression of clinical worsening. Unfortunately, many patients do not seek therapy until significant deficits are present or often due to painful syndromes of concurrent lumbar degenerative disease. • The authors provide the first literature review to date addressing the management of tandem cervical and lumbar stenosis. • There is insufficient evidence in the literature to support the need for preemptive decompression for asymptomatic cervical cord compression with or without a correlative T2 hyperintense cord signal. • Early diagnosis of cervical stenosis is significant in the setting of newly symptomatic radiculopathy and/or myelopathy as each patient in this clinical setting should be followed closely, as the literature shows the tendency for a clinical progression to eventual cervical myelopathy.