Search

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.