Eighteen cervical myelopathy patients who had combined lumbar canal stenosis underwent one stage decompression surgery, between 1989 and 1993. There were 14 males and 4 females, with a mean age of 69 years. The underlying causative condition was cervical spondylosis in 13 patients, OPLL in 5, lumbar spondylosis in 16, and lumbar degenerative spondylolisthesis in 2. The method of cervical operation was expansive laminoplasty using sagittal splitting of the spinous process, and the lumbar operation performed was wide laminectomy. Operative results were evaluated according to the modified Japanese Orthopaedic Association (JOA) score, after a mean follow-up period of 1 year 2 months. The mean recovery rate was 39%, with a recovery of 50% or more achieved in 7 patients (39%). An advantage of the one stage operation was shortening the period of treatment. For establishing an accurate indication of one stage operation, a detailed history and also neurologic examination are most important. Image diagnosis is useful for supporting rather than confirmatory evidence.
