Isfahan University of Medical Sciences

Science Communicator Platform

Stay connected! Follow us on X network (Twitter):
Share this content! On (X network) By
Comparison of 1-Stage Versus 2-Stage Decompression, Fusion and Instrumentation Surgery in Patients With Coexisting Cervical and Lumbar Degenerative Spondylotic Disorders; a Prospective, Randomized, Controlled Clinical Trial Study



Rezvani M1 ; Ghaedamini A2 ; Tabesh H1
Authors
Show Affiliations
Authors Affiliations
  1. 1. Department of Neurosurgery, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
  2. 2. School of Medicine, Student Research Committee, Isfahan University of Medical Sciences, Isfahan, Iran

Source: Journal of Isfahan Medical School Published:2016

Abstract

Background: Coexistent involvement of cervical and lumbar spine with destructive spondylotic degenerative processes such as tandem spinal stenosis (TSS) can be managed with simultaneous or staged decompressions; though, a controversy exists regarding the surgical staging strategy and limited research is available on its operative management which are mostly retrospective. This randomized clinical trial was conducted to compare outcomes of simultaneous decompression, fusion and instrumentation of cervical and lumbar spine versus 2-stage operations. Methods: Twenty patients with TSS were randomly assigned to either of two groups; in the 1-stage group, simultaneous decompression, fusion and instrumentation of both cervical and lumbar spine were performed by two teams in a single operation. The 2- stage group underwent staged cervical and lumbar surgeries in 2 separate operations. Combined blood loss, transfused packed cells, operation time, recovery time, days of hospitalization, overall expenses, Oswestry Disability Index (ODI) and complications were compared between the two groups. Student T-test, Chi-square test and Pearson correlation were used for analyzing the data. Findings: Operation time, recovery time, days of hospitalization and overall expenses were significantly reduced in 1-stage surgery group. There were no significant differences between the two groups in terms of combined blood loss, transfused packed cells or postoperative complications. Early cervical and lumbar clinical outcomes which were evaluated by Oswestry neck and back disability index, respectively, were similar in two groups (P > 0.05). Conclusion: Single-stage surgery had comparable clinical outcomes compared to 2-stage operations without exposing the patients to unnecessary risks. © 2016. Isfahan University of Medical Sciences(IUMS). All rights reserved.
Related Docs
View other Related Docs
1. Posterolateral Instrumented Fusion With and Without Transforaminal Lumbar Interbody Fusion for the Treatment of Adult Isthmic Spondylolisthesis: A Randomized Clinical Trial With 2-Year Follow-Up, Journal of Craniovertebral Junction and Spine (2016)
2. Spondylodiscitis Instrumented Fusion, a Prospective Case Series on a Standardized Neurosurgical Protocol With Long Term Follow Up, Injury (2024)
3. A Comparative Study of L4-L5-S1 and L5-S1 Vertebral Fusion in High-Grade L5-S1 Spondylolisthesis, Journal of Craniovertebral Junction and Spine (2021)
4. Evaluating of the Results of Long Fusion Surgery in Patients With Degenerative Lumbar Scoliosis, Tehran University Medical Journal (2021)
5. The Quality of Life of 50-70 Years Old Patients With Orthopedic Spinal Stenosis Surgery. a Follow-Up Study (Descriptive Study), Caspian Journal of Internal Medicine (2023)
6. In-Fracture Pedicular Screw Placement During Ligamentotaxis Following Traumatic Spine Injuries, a Randomized Clinical Trial on Outcomes, Korean Journal of Neurotrauma (2023)
7. Comparison of Open Surgical Discectomy Versus Plasma-Laser Nucleoplasty in Patients With Single Lumbar Disc Herniation, Journal of Research in Medical Sciences (2015)
8. Evaluation of Treatment Results of Posterior Approach Surgery in Patients With Cervical Spondylotic Myelopathy, Journal of Babol University of Medical Sciences (2020)
Experts (# of related papers)
View all Related Experts
Majid Rezvani (10)
Mehdi Mahmoodkhani (5)
Other Related Docs
9. Effect of High-Dose Intravenous Dexamethasone on Postlumbar Discectomy Pain, Spine (2006)
10. Autograft and Allograft Bone Chips Interbody Fusion for Spondylodiscitis: Surgery Outcomes, Caspian Journal of Internal Medicine (2023)
11. Investigation of Functional Disability, Psychological Status, and Quality of Life of Patients Undergoing Lumbar Disc Surgery, Journal of Military Medicine (2023)
12. Effects of Perioperative Use of Two Doses of Magnesium Sulfate Infusion on Intraoperative Blood Loss in Patients Undergoing Lumbar Spinal Fusion Surgery, Journal of Emergency Practice and Trauma (2023)
13. Lumbosacral Transitional Vertebra in Spondylolisthesis: Frequency, Demographic Findings, and Clinical Characteristics, BMC Musculoskeletal Disorders (2024)
14. Prevalence and Incidence of Early and Late Complications of Lumbar Spine Fusion Surgery in Alzahra and Kashani Hospitals in Isfahan City, Iran, During 2011-2015, Journal of Isfahan Medical School (2016)
15. Comparison of the Outcomes of Cage-Stand-Alone With Cage-With-Plate Fixation in One Level and Two Levels for Treating Cervical Disk Diseases, Journal of Craniovertebral Junction and Spine (2018)
16. Lumbar Sacralization and L4-L5 Microdiscectomy, a Prospective Cohort Study on Radiologic and Clinical Outcomes, World Neurosurgery: X (2024)
17. Single Level Cervical Disc Herniation: A Questionnaire Based Study on Current Surgical Practices, Indian Journal of Orthopaedics (2009)
18. Effect of Posterior Fusion Surgery on Idiopathic Scoliosis in Iran, Journal of Craniovertebral Junction and Spine (2019)
19. Postoperative Complications of Posterior Fusion With Instrumentation in Adult Patients With Idiopathic Scoliosis, Journal of Isfahan Medical School (2017)
20. Analgesic Effects of Ketamine Infusion on Postoperative Pain After Fusion and Instrumentation of the Lumbar Spine: A Prospective Randomized Clinical Trial., Medicinski arhiv (2012)
21. A Short-Term Oral Corticosteroid for Refractory Lumbar Spinal Stenosis: A Double-Blinded Randomized Placebo-Controlled Clinical Trial, International Journal of Rehabilitation Research (2020)
22. Comparison of Scheuermann’S Kyphosis Correction by Combined Anterior–Posterior Fusion Versus Posterior-Only Procedure, European Spine Journal (2016)
23. Effectiveness of Transforaminal Steroid Injections in Spinal Canal Stenosis Grade 1 to 3, Interdisciplinary Neurosurgery: Advanced Techniques and Case Management (2024)
24. Value of Spinal Infection Treatment Evaluation Score, Pola Classification, and Brighton Spondylodiscitis Score From Decision to Surgery in Patients With Spondylodiscitis: A Receiveroperating Characteristic Curve Analysis, Asian Spine Journal (2024)
25. The Cost Effectiveness of Dynamic and Static Interspinous Spacer for Lumbar Spinal Stenosis Compared With Laminectomy, Medical Journal of the Islamic Republic of Iran (2016)