Concurrent stenoses in the cervical, thoracic, and lumbar spines |

Doctors in Korea announced their findings on patients with a seemingly overlooked spinal disorder – age-related degenerative changes causing concurrent stenoses in the cervical, thoracic, and lumbar spines (triple stenosis).

They looked at 460 elderly patients with lumbar stenosis, 110 (23.9%) had concurrent radiologic cervical stenosis and 112 (24.3%) had concurrent radiologic thoracic stenosis.

Fifty-six patients (12.1%) had combined radiologic cervical and thoracic stenosis in addition to their symptomatic lumbar stenosis (triple stenosis).

Anterior epidural stenosis at C7–T1 was associated with a high prevalence of thoracic stenosis.

They concluded, patients with symptomatic lumbar stenosis often have asymptomatic radiologic cervical and thoracic spinal stenosis. Although the majority of these cases probably remain asymptomatic, some may become symptomatic over time.

Furthermore, with prolonged surgical positioning during lumbar decompression, they may become symptomatic.

This agrees with research in the medical journal Osteoarthritis and Cartilage researchers in Japan discovered that many patients with no complaints or symptoms of stenosis have radiographic lumbar spinal stenosis (LSS). In 938 patients with an average age of about 66, they found that when they did an MRI, Lumbar Spinal Stenosis was very prevalent. When they asked the patients if they had back pain or other spinal problems, most said no .1 This made for confusion the MRI says send them to surgery, the patients says nothing is bothering them.

Read more about the controversy surrounding failed back surgery syndrome and MRI as a risk factor for failed back surgery syndrome.

1. Park MS, Moon SH, Kim TH, Oh JK, Lyu HD, Lee JH, Riew KD. Asymptomatic Stenosis in the Cervical and Thoracic Spines of Patients with Symptomatic Lumbar Stenosis. Global Spine J. 2015 Oct;5(5):366-71. doi: 10.1055/s-0035-1549031. Epub 2015 Mar 27.

2. Ishimoto† Y, Noriko Y, Shigeyuki M, Hiroshi Y, et al.  Associations between radiographic lumbar spinal stenosis and clinical symptoms in the general population: The Wakayama Spine Study. Osteoarthritis Cartilage. 2013 Mar 5. pii: S1063-4584(13)00706-1. doi: 10.1016/j.joca.2013.02.656. [Epub ahead of print]