{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,10]],"date-time":"2026-03-10T08:54:48Z","timestamp":1773132888776,"version":"3.50.1"},"reference-count":26,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2021,2,22]],"date-time":"2021-02-22T00:00:00Z","timestamp":1613952000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["81902209"],"award-info":[{"award-number":["81902209"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Orthopaedic Surgery"],"published-print":{"date-parts":[[2021,4]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>The aim of the present paper was to reveal the clinical differences between selective and nonselective decompression for symptomatic tandem stenosis of the cervical and thoracic spine (TSCTS).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A total of 34 patients were eligible and included in the study. Among them, 8 patients underwent selective cervical decompression (CD), 15 patients underwent selective thoracic decompression (TD), and 11 patients underwent combined CD and TD (CTD) surgery. Age, sex, operative time, intraoperative blood loss, postoperative hospital stay, inpatient expenditure, preoperative upper Japanese Orthopaedic Association (JOA) rate, canal occupation rate, high\u2010intensity T2\u2010weighted image (T2WI) of the spinal cord, and preoperative and postoperative JOA scores were compared among the three groups.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The CD group had shorter operative time (138.8\u2009\u00b1\u200936.1 <jats:italic>vs<\/jats:italic> 229.7\u2009\u00b1\u200995.8 <jats:italic>vs<\/jats:italic> 328.6\u2009\u00b1\u200994.8, min, <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001), less intraoperative blood loss (141.3\u2009\u00b1\u2009116.7 <jats:italic>vs<\/jats:italic> 496.7\u2009\u00b1\u2009361.8 <jats:italic>vs<\/jats:italic> 654.6\u2009\u00b1\u2009320.5, mL, <jats:italic>P<\/jats:italic> = 0.004), and shorter postoperative hospital stay (4.6\u2009\u00b1\u20091.6 <jats:italic>vs<\/jats:italic> 9.0\u2009\u00b1\u20093.5 <jats:italic>vs<\/jats:italic> 10.3\u2009\u00b1\u20096.6, days, <jats:italic>P<\/jats:italic> = 0.008), as well as lower preoperative upper JOA rate (34.1\u2009\u00b1\u20095.6 <jats:italic>vs<\/jats:italic> 53.9\u2009\u00b1\u20098.4 <jats:italic>vs<\/jats:italic> 48.2\u2009\u00b1\u200915.2, %, <jats:italic>P<\/jats:italic> = 0.001) than the TD and CTD groups. The CTD group had higher inpatient expenditure than the CD and TD groups (87,850\u2009\u00b1\u200918,379 <jats:italic>vs<\/jats:italic> 55,100\u2009\u00b1\u200912,890 <jats:italic>vs<\/jats:italic> 55,772\u2009\u00b1\u200915,715, CNY, <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001). The cervical canal occupation rates were similar among different groups (<jats:italic>P<\/jats:italic>\u2009&gt;\u20090.05); however, the TD group showed a higher thoracic canal occupation rate than the CD group (58.3\u2009\u00b1\u200914.7 <jats:italic>vs<\/jats:italic> 43.3\u2009\u00b1\u200912.3, %, <jats:italic>P<\/jats:italic> = 0.035). All positive levels in high\u2010intensity T2WI of the spinal cord were decompressed. The preoperative JOA scores as well as the postoperative JOA scores at 6\u2009months and at last follow\u2010up were comparable among the three groups (<jats:italic>P<\/jats:italic> &gt;\u20090.05). Similarly, the JOA recovery rate showed no significant difference among the groups (<jats:italic>P<\/jats:italic> &gt;\u20090.05).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Selective CD or TD alone demonstrated similar clinical effectiveness to nonselective and combined CTD for TSCTS. Individualized surgical decision should be made after meticulous assessments of clinical and radiological manifestations, general patient condition, and socioeconomic factors.<\/jats:p><\/jats:sec>","DOI":"10.1111\/os.12889","type":"journal-article","created":{"date-parts":[[2021,2,23]],"date-time":"2021-02-23T06:59:08Z","timestamp":1614063548000},"page":"537-545","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Clinical Comparison of Selective <i>versus<\/i> Nonselective Decompression for Symptomatic Tandem Stenosis of the Cervical and Thoracic Spine: A Retrospective Cohort Study"],"prefix":"10.1111","volume":"13","author":[{"given":"Chao","family":"Wang","sequence":"first","affiliation":[{"name":"Department of Spine Surgery The Affiliated Hospital of Qingdao University  Qingdao 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