Minimally invasive spine surgery enabling the feasibility of single-stage surgery for tandem spinal stenosis

Introduction: Tandem spinal stenosis (TSS) is a rare presentation leading to combined clinical features of upper and lower motor neuron. Scarce literature on its presentation and management is available. There are few studies recommending single stage surgery. Furthermore, no previous studies have included minimally invasive surgeries (MIS). Objective: To evaluate the clinical outcomes of single stage surgery for symptomatic TSS in elderly patients and also the safety and effectiveness of minimally invasive surgeries in TSS patients. MaterialandMethods: We reviewed the data of 50 patients with TSS who underwent surgery from January 2014 to June 2021. The medical records were reviewed for demographic, peri-operative data, and previously documented follow-up were collected from the case records. Results were evaluated with Nurick grading, Oswestry Disability Index (ODI), Modified Japanese Orthopedic Association (mJOA), Visual Analog Scale (VAS) for back pain and leg pain, blood loss, and complications. Results: The median age of patients was 66 years (range: 53–89 years). The median estimated blood loss of TSS patients undergoing simultaneous decompression was 180 ml (150–220). The median operative time was 200 min (170–250). There was a significant improvement in mJOA, Nurick grading, ODI, and VAS postoperatively as compared to preoperative values. There were no major complications. Conclusion: Symptomatic TSS can be safely managed by single-stage surgical intervention with good postoperative results without a significant increase in complications.