Tandem spinal stenosis (TSS) is defined as the concomitant occurrence of stenosis in at least two or more distinct regions (cervical, thoracic, or lumbar) of the spine and may present with a constellation of signs and symptoms. It has four subtypes, including cervico-lumbar, cervico-thoracic, thoraco-lumbar, and cervico-thoraco-lumbar TSS. The prevalence of TSS varies depending on the different subtypes and cohorts. The main aetiologies of TSS are spinal degenerative changes and heterotopic ossification, and patients with developmental spinal stenosis, ligament ossification, and spinal stenosis at any region are at an increased risk of developing TSS. The diagnosis of TSS is challenging. The clinical presentation of TSS could be complex, concealed, or severe, and these features may be confusing to clinicians, resulting in an incomplete or delayed diagnosis. Additionally, a consolidated diagnostic criterion for TSS is urgently required to improve consistency across studies and form a basis for establishing treatment guidelines. The optimal treatment option for TSS is still under debate; areas of controversies include choice of the decompression range, choice between simultaneous or staged surgical patterns, and the order of the surgeries. The present study reviews publications on TSS, consolidates current awareness on prevalence, aetiologies, potential risk factors, diagnostic dilemmas and criteria, and surgical strategies based on TSS subtypes. This is the first review to include thoracic spinal stenosis as a candidate disorder in TSS and aims at providing the readers with a comprehensive overview of TSS.

中文翻译：

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目前对串联椎管狭窄症的理解：流行病学、诊断和手术策略。

串联椎管狭窄症 (TSS) 被定义为在脊柱的至少两个或多个不同区域（颈椎、胸椎或腰椎）同时发生狭窄，并可能出现一系列体征和症状。它有四种亚型，包括颈腰椎、颈胸椎、胸腰椎和颈胸腰椎TSS。TSS 的患病率因不同的亚型和队列而异。TSS的主要病因是脊柱退行性改变和异位骨化，任何部位有发育性椎管狭窄、韧带骨化和椎管狭窄的患者发生TSS的风险增加。TSS 的诊断具有挑战性。TSS 的临床表现可能复杂、隐匿或严重，这些特征可能会让临床医生感到困惑，导致诊断不完整或延迟。此外，迫切需要一个综合的 TSS 诊断标准，以提高研究的一致性，并为制定治疗指南奠定基础。TSS 的最佳治疗方案仍在争论中；争议的领域包括减压范围的选择、同时或分阶段手术模式的选择以及手术的顺序。本研究回顾了有关 TSS 的出版物，巩固了当前对患病率、病因、潜在风险因素、诊断困境和标准以及基于 TSS 亚型的手术策略的认识。这是第一篇将胸椎管狭窄症列为 TSS 候选疾病的综述，旨在为读者提供 TSS 的全面概述。迫切需要一个综合的 TSS 诊断标准，以提高研究的一致性，并为制定治疗指南奠定基础。TSS 的最佳治疗方案仍在争论中；争议的领域包括减压范围的选择、同时或分阶段手术模式的选择以及手术的顺序。本研究回顾了有关 TSS 的出版物，巩固了当前对患病率、病因、潜在风险因素、诊断困境和标准以及基于 TSS 亚型的手术策略的认识。这是第一篇将胸椎管狭窄症列为 TSS 候选疾病的综述，旨在为读者提供 TSS 的全面概述。迫切需要一个综合的 TSS 诊断标准，以提高研究的一致性，并为制定治疗指南奠定基础。TSS 的最佳治疗方案仍在争论中；争议的领域包括减压范围的选择、同时或分阶段手术模式的选择以及手术的顺序。本研究回顾了有关 TSS 的出版物，巩固了当前对患病率、病因、潜在风险因素、诊断困境和标准以及基于 TSS 亚型的手术策略的认识。这是第一篇将胸椎管狭窄症列为 TSS 候选疾病的综述，旨在为读者提供 TSS 的全面概述。