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Dear editor,
We read the article “Primary cervical decompression surgery may improve lumbar symptoms in patients with tandem spinal stenosis” by Inoue T, et al. [1] with great interest and had a long deliberation and appraisal on the different aspects discussed in the concerned article. At the go, we congratulate the authors for selecting a retrospective analysis of a common combination of stenosis, but scarcely described in literature.
Certain significant points of concern which need redressal are:
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1.
Any specific reason/reasons mentioned and analysed in the literature to conduct myelography and computed tomography for all patients with LSS to evaluate the cervical lesion and the lumbar spine; MRI in one go would have been the diagnostic modality of choice, all the more non-invasive.
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Reason for the proportion of males in the relapsed group being higher than the non-improved group and the finding of no significant difference in terms of sex between the non-improved and maintained-improvement groups.
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Is this retrospective study with only 14 subjects maintaining improvement in LSS symptoms following cervical decompression in a total Japanese cohort of 64 only, worth recommending for the surgeons worldwide?
Reference
Inoue T, Ando K, Kobayashi K, Nakashima H, Ito K, Katayama Y, Machino M, Kanbara S, Ito S, Yamaguchi H, Koshimizu H, Segi N, Kato F, Imagama S (2021) Primary cervical decompression surgery may improve lumbar symptoms in patients with tandem spinal stenosis. Eur Spine J. https://doi.org/10.1007/s00586-020-06693-0
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Kumar, V., Dhatt, S.S., Subramaniyam, S.R. et al. Letter to the editor concerning "primary cervical decompression surgery may improve lumbar symptoms in patients with tandem spinal stenosis" by Inoue T, et al. (Eur Spine J; 2021 jan 6. doi: 10.1007/s00586-020-06,693-0). Eur Spine J 30, 1789 (2021). https://doi.org/10.1007/s00586-021-06801-8
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DOI: https://doi.org/10.1007/s00586-021-06801-8