Three region spinal decompression in the same session: a case report.

Area of Science:

• Neurosurgery
• Spinal Surgery
• Neurology

Background:

• Multiregional spinal stenosis, also known as tandem spinal stenosis (TSS), involves narrowing in multiple spinal segments.
• While TSS is relatively common, simultaneous surgical decompression of cervical and lumbar spine occurs in 5-25% of TSS cases.
• Surgical intervention for three distinct spinal regions in a single session is exceptionally rare, with only one prior case documented in medical literature.

Observation:

• A 72-year-old male presented with debilitating symptoms including leg and arm pain, neurogenic claudication, impaired balance, and signs of radiculopathy and myelopathy affecting both upper and lower extremities.
• The patient underwent a single-session decompressive surgery addressing cervical-thoracic and lumbar spinal stenosis.
• The total surgical duration was 330 minutes, with no immediate postoperative complications observed.

Findings:

• The patient demonstrated a favorable recovery, being mobilized on postoperative day 1 and discharged on day 3.
• Significant improvement in motor function was noted by 3 months post-surgery, with a near-complete recovery.
• A notable decrease in pyramidal signs was also observed within the same timeframe.

Implications:

• This case highlights the successful surgical management of extremely rare multiregional spinal stenosis involving three spinal regions in a single operative session.
• It suggests that complex, multi-region spinal decompression is a viable option for carefully selected patients with severe, widespread spinal stenosis.
• Further investigation into the long-term outcomes and patient selection criteria for such extensive procedures is warranted.