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Research ArticleCervical Spine

Demographic and Clinical Characteristics of Patients With Cervical Spine Degeneration Reveal Frequent Cervicolumbar Tandem Spinal Stenosis in Mexico

Parménides Guadarrama-Ortiz, César Osvaldo Ruíz-Rivero, Deyanira Capi-Casillas, Alondra Román-Villagómez, Ángel Daniel Prieto-Rivera and José Alberto Choreño-Parra
International Journal of Spine Surgery October 2023, 17 (5) 670-677; DOI: https://doi.org/10.14444/8520
Parménides Guadarrama-Ortiz
1 Department of Neurosurgery, Centro Especializado en Neurocirugía y Neurociencias México, Mexico City, Mexico
MD
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  • For correspondence: dr.guadarrama.ortiz@cennm.com investigacion.cientifica@cennm.com
César Osvaldo Ruíz-Rivero
1 Department of Neurosurgery, Centro Especializado en Neurocirugía y Neurociencias México, Mexico City, Mexico
MD
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Deyanira Capi-Casillas
1 Department of Neurosurgery, Centro Especializado en Neurocirugía y Neurociencias México, Mexico City, Mexico
MD
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Alondra Román-Villagómez
1 Department of Neurosurgery, Centro Especializado en Neurocirugía y Neurociencias México, Mexico City, Mexico
MD
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Ángel Daniel Prieto-Rivera
1 Department of Neurosurgery, Centro Especializado en Neurocirugía y Neurociencias México, Mexico City, Mexico
RN
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José Alberto Choreño-Parra
2 Department of Clinical Research, Centro Especializado en Neurocirugía y Neurociencias México, Mexico City, Mexico
MD, PhD
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    Table 1

    Participant characteristics.

    Characteristics N = 50
    Demographic 
     Age, y54.0 (46.5, 68.8)
     Male gender13 (26%)
     Hispanic race50 (100%)
     Body mass index, kg/m2 26.6 (24.2, 30.3)
    Comorbidities 
     Hypertension14 (28%)
     Depression14 (28%)
     Anxiety14 (28%)
     Obesity13 (26%)
     Alcoholism13 (26%)
     Smoking11 (22%)
     Diabetes7 (14%)
     Renal failure3 (6.0%)
     Hepatic failure1 (2.0%)
     Previous surgery35 (70%)
    Clinical manifestations 
     Symptom duration, mo11.6 (0.0, 120)a
     Radicular arm/neck pain39 (80%)
     Paresthesia/tingling35 (70%)
     Reduced muscle strength24 (48%)
     Gait changes24 (48%)
     Numbness/hypoesthesia13 (26%)
     Headache8 (16%)
     Objective sensory impairment5 (10%)
    Radiological findings 
     Cervical segments, n 2.0 (2.0, 3.0)
      12 (4.0%)
      224 (48%)
      3 or more19 (38%)
     C5–C646 (92%)
     C4–C544 (88%)
     C6–C721 (42%)
     C3–C415 (30%)
     C2–C32 (4.0%)
     C7–T11 (2.0%)
     Disc herniation44 (88%)
     Foramen stenosis33 (67%)
     Central canal stenosis19 (38%)
     Ligament flavum hypertrophy12 (24%)
     Myelopathy11 (22%)
     Spondylolisthesis2 (4.0%)
    Vital signs 
     Temperature, °C36.3 (36.1, 36.5)
     Heart rate, bpm76.0 (70.0, 88.0)
     Respiratory rate, rpm19.0 (18.0, 20.0)
     Mean arterial blood pressure, mmHg86.7 (82.5, 93.3)
      >100 mmHg6/46 (13%)
     Saturation, %94.0 (92.0, 95.0)
    Laboratory parameters 
     White blood cells, per μL7200.0 (5900.0, 8900.0)
      >10,000 /μL7/44 (16%)
     Neutrophils, per μL4597.0 (3382.2, 6041.0)
      >8000 /μL7/39 (18%)
     Lymphocytes, per μL1978.0 (1696.5, 2434.0)
      <1000 /μL3/39 (7.7%)
     Hemoglobin, g/dL14.3 (13.6, 15.6)
     Anemia6/43 (14%)
     Hematocrit, %44.0 (39.8, 46.3)
     Platelets, per μL262.0 (236.2, 305.0)
     Glucose, mg/dL98.0 (87.0, 108.0)
      >126 mg/dL9/45 (20%)
     Blood urea nitrogen, mg/dL14.2 (12.1, 22.0)
      >20 mg/dL13/41 (32%)
     Creatinine, mg/dL0.7 (0.7, 0.9)
      >1.1 mg/dL5/45 (11%)
     Uric acid, mg/dL5.1 (3.7, 6.1)
      >8.5 mg/dL1/43 (2.3%)
     Na, mEq/L139.0 (138.0, 142.0)
     K, mmol/L4.0 (3.8, 4.4)
     Ca, mg/dL9.3 (9.1, 9.6)
     Bilirubin, mg/dL0.5 (0.3, 0.7)
      >1.2 mg/dL1/38 (2.6%)
     Aspartate aminotransferase, U/L22.0 (19.0, 27.0)
      >33 U/L6/37 (16%)
     Alanine aminotransferase, U/L27.5 (16.8, 35.5)
      >36 U/L9/36 (25%)
     Lactate dehydrogenase, IU/L219.5 (183.2, 415.0)
      >280 IU/L14/34 (41%)
     Cholesterol, mg/dL198.0 (165.0, 208.0)
      >200 mg/dL19/41 (46%)
     Triglycerides, mg/dL181.9 (112.5, 236.0)
      >150 mg/dL29/40 (72%)
    • Note: Data are displayed as n (%), n/N (%), or median (interquartile range).

    • ↵a Duration of symptoms is displayed as median with range. N is the total number of participants with available information.

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    Table 2

    Lumbar spine changes in patients with degenerative cervical spinal disease.

    Characteristics N = 50
    Cervicolumbar tandem spinal stenosis24 (48%)
    Lumbar segments, n2.0 (1.0, 2.0)
     13 (12%)
     214 (58%)
     ≥37 (29%)
    L4–L523 (46%)
    L5–S122 (44%)
    L3–L43 (6.0%)
    L1–L21 (2.0%)
    L2–L31 (2.0%)
    • Note: Data are displayed as n (%) or median (interquartile range).

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    Table 3

    Comparison of demographic and clinical characteristics of patients with CLTSS.

    CharacteristicsCLTSS
    N = 24
    Non-CLTSS
    N = 26
    P Value
    Demographics   
     Age, y61.0 (52.0, 73.0)51.5 (44.5, 60.0)0.022
     Male gender8 (33%)5 (19%)0.3
     Body mass index, kg/m2 26.6 (23.8, 31.4)26.3 (24.2, 29.6)0.9
    Comorbidities   
     Obesity7 (29%)6 (23%)0.6
     Hypertension11 (46%)3 (12%)0.007
     Depression11 (46%)3 (12%)0.007
     Anxiety9 (38%)5 (19%)0.2
     Alcoholism6 (25%)7 (27%)0.9
     Smoking5 (21%)6 (23%)0.8
     Diabetes5 (21%)2 (7.7%)0.2
     Renal failure2 (8.3%)1 (3.8%)0.6
     Hepatic failure1 (4.2%)0 (0%)0.5
     Previous surgery18 (75%)17 (65%)0.5
    Clinical manifestations   
     Symptom duration, mo16.0 (0.0, 120)7.1 (0.0, 58.0)0.023
     Radicular/neck pain18 (78%)21 (81%)>0.9
     Paresthesia/tingling17 (71%)18 (69%)>0.9
     Reduced muscle strength14 (58%)10 (38%)0.2
     Gait changes14 (58%)10 (38%)0.2
     Numbness/hypoesthesia8 (33%)5 (19%)0.3
     Headache5 (21%)3 (12%)0.5
     Sensory impairment4 (17%)1 (3.8%)0.2
    Radiological findings   
     Cervical segments, n  2.5 (2.0, 3.0) 2.0 (2.0, 3.0) 0.4
     1 0 (0%) 2 (7.7%) 0.5
     2 12 (50%) 12 (46%) 0.8
     3 8 (33%) 11 (42%) 0.5
     4 or more 4 (17%) 1 (3.8%) 0.2
     C2–C3 2 (8.3%) 0 (0%) 0.2
     C3–C4 10 (42%) 5 (19%) 0.084
     C4–C5 21 (88%) 23 (88%)  >0.9
     C5–C6 21 (88%) 25 (96%) 0.3
     C6–C7 11 (46%) 10 (38%) 0.6
     C7–T1 1 (4.2%) 0 (0%) 0.5
     Disc herniation 21 (88%) 23 (88%)  >0.9
     Foraminal stenosis 17 (74%) 16 (62%) 0.4
     Central canal stenosis 12 (50%) 7 (27%) 0.093
     Myelopathy 7 (29%) 4 (15%) 0.2
     Ligament flavum hypertrophy 5 (21%) 7 (27%) 0.6
     Spondylolisthesis 2 (8.3%) 0 (0%) 0.2
    • Abbreviation: CLTSS, cervicolumbar tandem spinal stenosis.

    • Note: Data are displayed as n (%) or median (interquartile range).

    • a Duration of symptoms is displayed as median with range. N is the total number of participants with available information. Differences between groups were analyzed with the Fisher exact test, χ 2 test, or Mann-Whitney U test, as appropriate.

    • View popup
    Table 4

    Vital signs and laboratory parameters of patients with CLTSS.

    CharacteristicsCLTSS
    N = 24
    Non-CLTSS
    N = 26
    P Value
    Vital signs
     Temperature, °C36.3 (36.0, 36.5)36.3 (36.2, 36.5)0.7
     Heart rate, bpm78.0 (72.0, 88.0)75.0 (70.0, 87.0)0.5
     Respiratory rate, rpm19.0 (18.0, 20.0)20.0 (18.0, 20.0)0.5
     Mean arterial blood pressure, mmHg86.7 (83.3, 95.0)86.7 (80.0, 90.0)0.3
      >100 mmHg4/23 (17%)2/23 (8.3%)0.4
     Saturation, %93.0 (91.0, 95.0)94.0 (92.0, 95.0)0.2
    Laboratory parameters
     White blood cells, per μL7070.0 (5772.5, 8665.0)7300.0 (6000.0, 8900.0)0.4
       >10,000/μL3/22 (14%)4/22 (18%)> 0.9
     Neutrophils, per μL3834.0 (3401.5, 5790.0)5184.0 (3438.5, 6113.5)0.3
       >8000/μL4/21 (19%)3/18 (16%)> 0.9
     Lymphocytes, per μL1964.0 (1572.0, 2340.5)1978.0 (1763.0, 2530.5)0.3
       <1000 /μL2/20 (10%)1/19 (5.3%)> 0.9
     Hemoglobin, g/dL14.3 (13.6, 16.1)14.3 (14.0, 15.1)0.7
     Anemia2/21 (9.5%)4/22 (17%)0.7
     Hematocrit, %43.5 (39.0, 46.8)44.0 (41.4, 46.0)> 0.9
     Platelets, per μL256.0 (234.0, 305.0)262.0 (238.0, 304.0)> 0.9
     Glucose, mg/dL107.9 (98.0, 134.0)90.0 (83.8, 102.0)0.010
       >126 mg/dL7/21 (33%)2/24 (8.3%)0.061
     Blood urea nitrogen, mg/dL21.7 (14.2, 24.3)13.2 (10.8, 15.1)0.009
       >20 mg/dL9/17 (53%)4/24 (17%)0.014
     Creatinine, mg/dL0.8 (0.7, 0.9)0.7 (0.7, 0.8)0.2
       >1.1 mg/dL4/21 (19%)1/24 (4.2%)0.2
     Uric acid, mg/dL5.7 (4.0, 6.9)4.8 (3.7, 5.8)0.3
       >8.5 mg/dL0/19 (0%)1/24 (4.2%)> 0.9
     Na, mEq/L138.6 (137.0, 142.0)141.0 (138.0, 142.0)0.4
     K, mmol/L4.2 (3.9, 4.4)4.0 (3.8, 4.1)0.2
     Ca, mg/dL9.4 (9.2, 9.6)9.3 (9.1, 9.5)0.7
     Bilirubin, mg/dL0.3 (0.3, 0.5)0.5 (0.4, 0.7)0.025
       >1.2 mg/dL0/14 (0%)1/24 (4.2%)> 0.9
     Aspartate aminotransferase, U/L19.0 (18.0, 24.5)24.0 (20.2, 30.8)0.12
       >33 U/L1/15 (6.7%)5/22 (23%)0.4
     Alanine aminotransferase, U/L22.0 (16.3, 31.0)32.0 (18.5, 42.0)0.14
       >36 U/L1/14 (7.1%)8/22 (36%)0.062
     Lactate hydrogenase, IU/L219.5 (181.8, 346.8)234.0 (183.2, 427.8)0.7
       >280 IU/L4/12 (33%)10/22 (45%)0.5
     Cholesterol, mg/dL198.0 (139.5, 240.0)194.5 (169.2, 207.5)0.9
       >200 mg/dL9/19 (47%)10/22 (45%)> 0.9
     Triglycerides, mg/dL169.4 (108.8, 198.2)190.0 (160.0, 238.2)0.2
       >150 mg/dL11/18 (61%)18/22 (82%)0.14
    • Abbreviation: CLTSS, cervico-lumbar tandem spinal stenosis.

    • Note: Data are displayed as n (%), n/N (%), or median (interquartile range). N is the total number of participants with available information. Differences between groups were analyzed with the Fisher exact test, χ 2 test, or Mann-Whitney U test, as appropriate.

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International Journal of Spine Surgery
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Demographic and Clinical Characteristics of Patients With Cervical Spine Degeneration Reveal Frequent Cervicolumbar Tandem Spinal Stenosis in Mexico
Parménides Guadarrama-Ortiz, César Osvaldo Ruíz-Rivero, Deyanira Capi-Casillas, Alondra Román-Villagómez, Ángel Daniel Prieto-Rivera, José Alberto Choreño-Parra
International Journal of Spine Surgery Oct 2023, 17 (5) 670-677; DOI: 10.14444/8520

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Demographic and Clinical Characteristics of Patients With Cervical Spine Degeneration Reveal Frequent Cervicolumbar Tandem Spinal Stenosis in Mexico
Parménides Guadarrama-Ortiz, César Osvaldo Ruíz-Rivero, Deyanira Capi-Casillas, Alondra Román-Villagómez, Ángel Daniel Prieto-Rivera, José Alberto Choreño-Parra
International Journal of Spine Surgery Oct 2023, 17 (5) 670-677; DOI: 10.14444/8520
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