Combined form of developmental cervical-lumbar stenosis of the spinal canal in two young patients

Symptomatic combined cervical and lumbar developmental spinal canal stenosis without spondylosis in young patients has rarely been reported. Two such cases are presented here. The symptoms appeared at 21 and 18 years of age and progressed gradually for each patient. The main clinical manifestations included lower back pain, intermittent claudication, polyradiculopathy and myelopathy. Myelogram and computed tomography scanning showed developmental spinal canal stenosis without evidence of spondylosis in either the cervical or lumbar spine. Both of the patients underwent a canal expansive laminoplasty at the cervical level and a decompressive laminectomy at the lumbar level. They both showed satisfactory improvement after surgery. The pathologic features consisted mainly of thin and flat laminae at the cervical spine, and thick, hard laminae and facet joints at the lumbar spine. The mechanism of early onset of symptoms was probably due to the additive effects of irritation of both the spinothalamic tract at the cervical level and the nerve roots at the lumbar level. A one-staged operation is considered to be the most suitable treatment for this disease entity.