Surgical strategy for TSS should be individualized. In the presence of myelopathy, staged surgery prioritizing cervical decompression is recommended. In the absence of myelopathy, simultaneous decompression may be considered in patients who can tolerate longer operative times. We propose a treatment algorithm to guide surgical decision-making based on symptom predominance, presence of myelopathy, and patient comorbidities.
Kotheeranurak et al. (Mon,) studied this question.