ORIGINAL STUDY Acta Orthop. Belg., 2007, 73, 234-237 Spondylotic degeneration can manifest as tandem (concurrent) cervical and lumbar spinal stenosis. The primary manifestations include neurogenic claudica- tion, gait disturbance and a mixture of findings of myelopathy and polyradiculopathy in both the upper and lower extremities. The purpose of this retrospec- tive study was to report the existence and manage- ment of tandem (concurrent) cervical and lumbar spinal stenosis. Between 1998 and 2004, 8 patients (6 women and 2 men) were diagnosed with tandem spinal stenosis in a series of 230 patients who underwent surgery for spinal stenosis (3.4%). Three patients received cervi- cal surgery first and 5 patients lumbar surgery first. The Japanese Orthopaedic Association Score of all patients improved from an average of 8.1 preopera- tively to an average of 11.8 points at discharge and maintained an average of 12.7 points at final follow- up. Oswestry Disability Score improved from mean 58.1 to 29 at discharge and 19.3 at latest follow-up. All the patients had excellent or good results and none deteriorated neurologically. Although tandem spinal stenosis occurred relatively infrequently, we concluded that its possible presence should not be overlooked. The treatment plan must be designed according to the chief complaints and symptoms of the patient. Keywords : cervical spinal stenosis ; lumbar spinal stenosis ; tandem ; concurrent ; decompression. INTRODUCTION As the population ages, degenerative and spondylotic changes of the spine, both segmental and diffuse, are seen more often,. Although spinal stenosis can occur at any level, it presents mostly at the most mobile segments of the spine, the cervical and lumbar levels (4). A progressive loss of the available space secondary to degenerative changes may give rise to the symptoms and signs of spinal stenosis at one or multiple levels. At either end of the spine, the symptoms and clinical signs of steno- sis are a direct result of a critical reduction in the sagittal diameter sufficient to produce symptoms in either the central spinal canal or the lateral neural foramina and the lateral recesses (3). The combina- tion of spinal stenosis at different segments may also confuse the clinical signs and symptoms. Spondylotic degeneration can manifest as tandem (concurrent) cervical and lumbar spinal stenosis. It was first described by Teng and Papatheodorou in 1964 (11). In 1984, Epstein et al (4) reported that 5% Acta Orthopædica Belgica, Vol. 73 - 2 - 2007 No benefits or funds were received in support of this study Treatment approach in tandem (concurrent) cervical and lumbar spinal stenosis Mehmet A YDOGAN, Cagatay OZTURK, Cuneyt MIRZANLI, Omer KARATOPRAK, Mehmet TEZER, Azmi HAMZAOGLU From the Florence Nightingale Hospital, Istanbul, Turkey ■ Mehmet Aydogan, MD, Consultant. ■ Cagatay Ozturk, MD, Consultant. ■ Cuneyt Mirzanli, MD, Consultant. ■ Omer Karatoprak, MD, Consultant. ■ Mehmet Tezer, MD, Associate Professor. ■ Azmi Hamzaoglu, MD, Professor. Istanbul Spine Center, Florence Nightingale Hospital, Istanbul, Turkey. Correspondence : Cagatay Ozturk, Istanbul Spine Center, Florence Nightingale Hospital, Abide-i Hurriyet Caddesi, Sisli, Istanbul, Turkey. E-mail : rezocagatay@hotmail.com. © 2007, Acta Orthopædica Belgica.