neurosurgeryНейрохирургияRussian journal of neurosurgery1683-32952587-7569Издательский дом "МедИНК"10.17650/1683-3295-2021-23-1-146-153neurosurgery-1021Research ArticleОБЗОРЫ ЛИТЕРАТУРЫLITERATURE REVIEWТандемный спинальный стеноз: клиника, диагностика и хирургическая тактикаTandem spinal stenosis: clinical pattern, diagnosis and surgical tacticsФениксовВ. М.FeniksovV. M.

Виктор Михайлович Фениксов

Россия, 119049 Москва, Ленинский просп., 8

Viktor Mikhaylovich Feniksov

8 Leninsky Ave., Moscow 119049, Russia

fenixov@gmail.comЗеленковП. В.ZelenkovP. V.

Россия, 125047 Москва, ул. 4‑я Тверская-Ямская, 16

16 4 th Tverskaya-Yamskaya St., Moscow 125047, Russia

ГБУЗ «Городская клиническая больница № 1 им. Н. И. Пирогова Департамента здравоохранения г. Москвы»РоссияSity Clinical Hospital No. 1 n. a. N. I. Pirogov, Moscow Healthcare DepartmentRussian FederationФГАУ «Национальный медицинский исследовательский центр нейрохирургии им. Н. Н. Бурденко» Минздрава РоссииРоссияN.N. Burdenko National Medical Research Center for Neurosurgery, Ministry of Health of RussiaRussian Federation202104052021231146‑153Copyright © Фениксов В.М., Зеленков П.В., 20212021Фениксов В.М., Зеленков П.В.Feniksov V.M., Zelenkov P.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.therjn.com/jour/article/view/1021

В обзоре описаны особенности диагностики и лечения тандемного спинального стеноза. Тандемный спинальный стеноз – дегенеративное сужение спинномозгового канала в 2 и более отделах позвоночника. Диагностика изолированных стенозов позвоночного столба, как правило, не вызывает затруднений, в то время как диагностика тандемных спинальных стенозов достаточно сложна. Клиническая картина при данной патологии складывается из множества симптомов, что препятствует быстрому и точному выявлению всех уровней поражения и часто обусловливает позднюю постановку диагноза. Данные о распространенности тандемного спинального стеноза очень вариабельны, а его этиология полностью не изучена. Не существует и общепринятого алгоритма выбора метода лечения. В связи с этим для правильной интерпретации сложных проявлений заболевания нужна комплексная оценка клинической картины и результатов инструментальных исследований, что поможет предотвратить необратимые последствия недиагностированного тандемного спинального стеноза. При выборе метода оперативного лечения необходимо рассматривать возможность поэтапной декомпрессии спинного мозга на всех уровнях стеноза и отдавать приоритет декомпрессии проксимальных отделов позвоночника.

The purpose of this review is to present an up-to-date look at the features of diagnosis and treatment of tandem spinal stenosis. Tandem spinal stenosis is a degenerative narrowing of the spinal canal of two or more parts of the spine column. Diagnosis of the one-level degenerative spinal stenosis is commonly quite easy in the practice of a spinal surgeons, while the diagnosis of tandem spinal stenosis is often difficult. The clinical presentation of tandem spinal stenosis presents a constellation of different symptoms and often cause late diagnosis. Data on the prevalence of tandem spinal stenosis are very variable, and the etiology cannot be fully studied. Thereby, comprehensive assessments of the symptoms and imaging provide assistance with the accurate and timely diagnosis. The choice of surgical method should consider possibility of staged decompression of each stenotic levels with priority for proximal parts of spine column.

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The authors declare that there are no conflicts of interest present.