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The prevalence of tandem spinal stenosis and its characteristics in a population-based MRI study: The Wakayama Spine Study

European Spine Journal volume 26, pages 2529–2535 (2017)Cite this article

Abstract

Purpose

Tandem spinal stenosis (TSS) is a condition of combined spinal stenosis in the cervical and lumbar regions. The purpose of this study was to determine the prevalence of radiographic TSS and its association with developmental canal stenosis (DCS). The second purpose was to investigate the extent to which radiographic TSS is associated with cervical myelopathy and symptomatic LSS.

Methods

We recruited 1011 (336 men and 675 women) participants in this population-based study. After excluding those with a pacemaker, a history of cervical or lumbar surgery, disqualification, the MRI data of whole spine was analysed in 931 (mean, 67.3 years) participants. Cervical cord compression (CCC) and radiographic lumbar spinal stenosis (LSS) were evaluated by MRI. The canal-to-body ratio was also measured by plain X-ray. DCS was diagnosed as canal-to-body ratio <0.75. The diagnosis of cervical myelopathy and symptomatic LSS was made by presentation of both symptoms and radiographic compression using MRI.

Results

The prevalence of CCC was 24.7%, that of radiographic LSS was 30.2%, and that of radiographic TSS was 11.0% (men, 14.1%; women, 9.4%). The prevalence of TSS was significantly higher in the DCS group than in the non-DCS group (p < 0.001). Among the participants with radiographic TSS, the prevalence of cervical myelopathy and symptomatic LSS was 9.8 and 18.6%, respectively. The coexisting cervical myelopathy and symptomatic LSS was 6.1% in the participants with LSS.

Conclusions

The present study is the first population-based study to clarify TSS characteristic using whole-spine MRI.

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Acknowledgements

This study was supported by: Wakayama Medical Award for Young Researchers in 2014 to Keiji Nagata, H23-Choujyu-002 (Director, Toru Akune), H-25-Choujyu-007 (Director, Noriko Yoshimura), H25-Nanchitou (Men)-005 (Director, Sakae Tanaka), 201417014A (Director, Noriko Yoshimura), and H22-Choujyu-Wakate-007 (Director, Shigeyuki Muraki) from the Ministry of Health, Labour and Welfare; a Grant-in-Aid for Scientific Research (B26293139, B23390172 to Noriko Yoshimura, B2629333, C20591774 to Shigeyuki Muraki, C26462249 to Hiroshi Hashizume, C25462305 to Hiroshi Yamada); a Grant-in-Aid for Young Researchers (B25860448 to Yuyu Ishimoto, B26860419 to Ryohei Kagotani, B15K20013 to Hiroki Iwahashi); a Grant-in-Aid for Challenging Exploratory Research (15K15219 to Noriko Yoshimura, 26670307 to Shigeyuki Muraki, 24659666 to Hiroyuki Oka, 25670293 to Toru Akune) of JSPS KAKENHI grant; This study also was supported by grants from the Japan Osteoporosis Society (Noriko Yoshimura, Shigeyuki Muraki, Hiroyuki Oka, and Toru Akune), a grant from JA Kyosai Research Institute (Hiroyuki Oka), grants from Mitsui Sumitomo Insurance Welfare Foundation (Shigeyuki Muraki), and research aid from the Japanese Orthopaedic Association (JOA-Subsidized Science Project Research 2006-1 and 2010-2; Director, Hiroshi Kawaguchi). The study sponsors played no role in the study design, the collection, analysis, and interpretation of data, writing of the report, or the decision to submit the paper for publication. The corresponding author had full access to all the data and had the final decision to submit for publication. The authors wish to thank Dr. Takako Nojiri and Mr. Kazuhiro Hatanaka of the Gobo Public Health Centre; Dr. Naoki Hirabayashi of the Kawakami Clinic, Hidakagawa Town; Mrs. Tomoko Takijiri, Mrs. Kumiko Shinou, Mrs. Rie Takiguchi, Mrs. Kyoko Maeda, Ms. Ikuyo Ueyama, Mrs. Michiko Mori, Mrs. Hisayo Sugimoto, and other members of the public office in Hidakagawa Town; Dr. Shinji Matsuda of the Shingu Public Health Centre; and Mrs. Tamako Tsutsumi, Mrs. Kanami Maeda, Mr. Shoichi Shimoichi, Mrs. Megumi Takino, Mrs. Shuko Okada, Mrs. Kazuyo Setoh, Mrs. Chise Ryouno, Mrs. Miki Shimosaki, Mrs. Chika Yamaguchi, Mrs. Yuki Shimoji, and other members of the public office in Taiji Town for their assistance in locating and scheduling participants for examinations. We also thank Ms. Kyoko Yoshimura, Mrs. Toki Sakurai, and Mrs. Saeko Sahara for their assistance with data reduction and administration.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, Wakayama Medical University, 811-1 Kimidera, Wakayama, Wakayama, 641-8509, Japan

    Keiji Nagata, Hiroshi Hashizume, Yuyu Ishimoto, Hiroshi Yamada & Munehito Yoshida

  2. Department of Joint Disease Research, Faculty of Medicine, 22nd Century Medical and Research Center, The University of Tokyo, Tokyo, Japan

    Noriko Yoshimura & Shigeyuki Muraki

  3. Department of Medical Research and Management for Musculoskeletal Pain, 22nd Century Medical and Research Center, Faculty of Medicine, The University of Tokyo, Tokyo, Japan

    Hiroyuki Oka

  4. Japan Community Healthcare Organization Tokyo Shinjuku Medical Center, Tokyo, Japan

    Hiroshi Kawaguchi

  5. Rehabilitation Services Bureau, National Rehabilitation Center for Persons with Disabilities, Tokorozawa, Saitama, Japan

    Toru Akune & Kozo Nakamura

  6. Department of Orthopaedic Surgery, Faculty of Medicine, The University of Tokyo, Tokyo, Japan

    Sakae Tanaka

Authors
  1. Keiji Nagata
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  2. Noriko Yoshimura
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  3. Hiroshi Hashizume
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  4. Yuyu Ishimoto
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  5. Shigeyuki Muraki
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  6. Hiroshi Yamada
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  7. Hiroyuki Oka
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  8. Hiroshi Kawaguchi
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  9. Toru Akune
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  10. Sakae Tanaka
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  11. Kozo Nakamura
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  12. Munehito Yoshida
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Corresponding author

Correspondence to Hiroshi Hashizume.

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Nagata, K., Yoshimura, N., Hashizume, H. et al. The prevalence of tandem spinal stenosis and its characteristics in a population-based MRI study: The Wakayama Spine Study. Eur Spine J 26, 2529–2535 (2017). https://doi.org/10.1007/s00586-017-5072-0

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  • DOI: https://doi.org/10.1007/s00586-017-5072-0

Keywords

  • Cervical cord compression
  • Lumbar spinal stenosis
  • Developmental canal stenosis
  • Canal-to-body ratio
  • Tandem spinal stenosis