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Abstract：
BACKGROUND: Tandem spinal stenosis (TSS) is a condition characterized by the narrowing of the spinal canal in multiple segments of the spine. Predominantly observed in the cervical and lumbar regions, TSS also manifests in the conjunction of the cervical and thoracic spine. The simultaneous occurrence of cervical and thoracic spinal stenosis engenders intricate symptoms, potentially leading to missed and delayed diagnosis. Furthermore, the presence of tandem cervical and thoracic stenosis (TCTS) introduces a notable impact on the decision-making calculus of surgeons when contemplating either one-staged or two-staged surgery. Currently, there is no agreed-upon strategy for surgical intervention of TCTS in the literature.
METHODS: Medical databases in English (Pubmed, Web of Science, Embase, the Cochrane Database of Systematic Reviews) and Chinese (CNKI, Wanfang Data, VIP CMJD) were searched using Medical Subject Heading queries for the terms \"tandem cervical and thoracic stenosis\", \"cervical stenosis AND thoracic stenosis\", \"tandem spinal stenosis\" and \"concomitant spinal stenosis\" from January 1980 to March 2023. We included studies involving adult individuals with TCTS. Articles exclusively focused on disorders within a single spine region or devoid of any mention of spinal disorders were excluded.
RESULTS: Initially, a total of 1625 literatures underwent consideration for inclusion in the study. Following the elimination of the duplicates through the utilization of EndNote, and a meticulous screening process involving scrutiny of abstracts and full-texts, 23 clinical studies met the predefined inclusion criteria. Of these, 2 studies solely focused on missed diagnosis, 19 studies exclusively discussed surgical strategy for TCTS, and 2 articles evaluated both surgical strategy and missed diagnosis.
CONCLUSIONS: Our study revealed a missed diagnosis rate of 7.2% in TCTS, with the thoracic stenosis emerging as the predominant area susceptible to oversight. Therefore, the meticulous identification of TCTS assumes paramount significance as the inaugural step in its effective management. While both one-staged and two-staged surgeries have exhibited efficacy in addressing TCTS, the selection of the optimal surgical plan should be contingent upon the individualized circumstances of the patients.
METHODS: Medical databases in English (Pubmed, Web of Science, Embase, the Cochrane Database of Systematic Reviews) and Chinese (CNKI, Wanfang Data, VIP CMJD) were searched using Medical Subject Heading queries for the terms \"tandem cervical and thoracic stenosis\", \"cervical stenosis AND thoracic stenosis\", \"tandem spinal stenosis\" and \"concomitant spinal stenosis\" from January 1980 to March 2023. We included studies involving adult individuals with TCTS. Articles exclusively focused on disorders within a single spine region or devoid of any mention of spinal disorders were excluded.
RESULTS: Initially, a total of 1625 literatures underwent consideration for inclusion in the study. Following the elimination of the duplicates through the utilization of EndNote, and a meticulous screening process involving scrutiny of abstracts and full-texts, 23 clinical studies met the predefined inclusion criteria. Of these, 2 studies solely focused on missed diagnosis, 19 studies exclusively discussed surgical strategy for TCTS, and 2 articles evaluated both surgical strategy and missed diagnosis.
CONCLUSIONS: Our study revealed a missed diagnosis rate of 7.2% in TCTS, with the thoracic stenosis emerging as the predominant area susceptible to oversight. Therefore, the meticulous identification of TCTS assumes paramount significance as the inaugural step in its effective management. While both one-staged and two-staged surgeries have exhibited efficacy in addressing TCTS, the selection of the optimal surgical plan should be contingent upon the individualized circumstances of the patients.
摘要：
背景：串联椎管狭窄（TSS）是一种以脊柱多个节段的椎管狭窄为特征的疾病。主要在颈椎和腰椎区域观察到，TSS还表现为颈椎和胸椎的结合。颈椎和胸椎管狭窄的同时发生会产生复杂的症状，可能导致漏诊和延迟诊断。此外，在考虑单阶段或两阶段手术时,串联颈椎和胸椎狭窄(TCTS)的存在会对外科医生的决策结石产生显著影响.目前,文献中没有达成一致的TCTS手术干预策略.
方法：英文医学数据库（Pubmed，WebofScience,Embase,Cochrane系统评价数据库)和中文(CNKI，万方数据,VIPCMJD）使用医学主题标题查询搜索术语“串联颈椎和胸椎狭窄”，“颈椎狭窄和胸椎狭窄”，1980年1月至2023年3月的“串联椎管狭窄”和“伴随椎管狭窄”。我们纳入了涉及患有TCTS的成人个体的研究。排除了仅关注单个脊柱区域内的疾病或没有提及脊柱疾病的文章。
结果：最初，共有1625篇文献被考虑纳入本研究.在通过使用EndNote消除重复项之后，细致的筛选过程，包括对摘要和全文的审查，23项临床研究符合预定的纳入标准。其中,2项研究仅关注漏诊，19项研究专门讨论了TCTS的手术策略，2篇文章评估了手术策略和漏诊。
结论：我们的研究显示TCTS的漏诊率为7.2％，胸椎狭窄成为容易受到监督的主要区域。因此,TCTS的细致识别作为其有效管理的第一步具有至关重要的意义。虽然单阶段和两阶段手术在解决TCTS方面都表现出了功效，最佳手术方案的选择应取决于患者的个性化情况。
方法：英文医学数据库（Pubmed，WebofScience,Embase,Cochrane系统评价数据库)和中文(CNKI，万方数据,VIPCMJD）使用医学主题标题查询搜索术语“串联颈椎和胸椎狭窄”，“颈椎狭窄和胸椎狭窄”，1980年1月至2023年3月的“串联椎管狭窄”和“伴随椎管狭窄”。我们纳入了涉及患有TCTS的成人个体的研究。排除了仅关注单个脊柱区域内的疾病或没有提及脊柱疾病的文章。
结果：最初，共有1625篇文献被考虑纳入本研究.在通过使用EndNote消除重复项之后，细致的筛选过程，包括对摘要和全文的审查，23项临床研究符合预定的纳入标准。其中,2项研究仅关注漏诊，19项研究专门讨论了TCTS的手术策略，2篇文章评估了手术策略和漏诊。
结论：我们的研究显示TCTS的漏诊率为7.2％，胸椎狭窄成为容易受到监督的主要区域。因此,TCTS的细致识别作为其有效管理的第一步具有至关重要的意义。虽然单阶段和两阶段手术在解决TCTS方面都表现出了功效，最佳手术方案的选择应取决于患者的个性化情况。
