Cervicothoracolumbar Multiregional Spinal Stenosis (MRSS): Outcomes of Single-Stage Surgery in a Case Series of 28 Patients With a Minimum Two-Year Follow-Up

Background Multiregional spinal stenosis (MRSS), defined as concomitant stenosis involving more than two nonconsecutive anatomically distinct spinal regions, represents a complex clinical entity with variable and often overlapping neurological manifestations. The coexistence of cervical, thoracic, and lumbar canal stenosis can obscure the primary symptomatic level, pose diagnostic challenges, and increase the risk of incomplete or staged management. Failure to recognize all affected regions may result in persistent symptoms and suboptimal functional recovery. This study aimed to characterize the clinicoradiological profile of cervicothoracolumbar MRSS and to evaluate the feasibility and perioperative parameters associated with single-stage surgical decompression. Materials and methods A retrospective cohort analysis was conducted on 28 consecutive patients who underwent single-stage surgical decompression for MRSS at a tertiary care center between January 2010 and March 2019, with a minimum follow-up duration of 24 months. Preoperative evaluation included a detailed neurological assessment and whole-spine MRI. Demographic characteristics, operative time (ORT), estimated blood loss (EBL), number of decompressed levels, surgical techniques employed, and intraoperative complications were recorded and analyzed. Results The study cohort comprised 28 patients (16 males and 12 females) with a mean age of 53.8 ± 9.6 years (range: 38-74 years). The mean ORT was 171.28 ± 48.13 minutes, and the mean EBL was 394.71 ± 131.14 mL. A total of 344 spinal levels were decompressed (mean: 12.28 levels per patient), involving the cervical (n = 123), thoracic (n = 151), and lumbar (n = 70) regions. Surgical procedures included anterior cervical decompression (n = 3), thoracic posterior instrumentation with pedicle screw fixation (n = 4), thoracic interbody fusion (n = 2), laminectomy (n = 9), and lumbar interbody fusion (n = 10). No major intraoperative complications were encountered. Conclusions MRSS should be strongly suspected in patients presenting with discordant, noncontiguous, or disproportionately severe neurological findings. Whole-spine MRI plays a pivotal role in identifying multiregional involvement and guiding comprehensive surgical planning. Single-stage decompression appears to be a safe and feasible strategy in carefully selected patients, demonstrating acceptable perioperative parameters.