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Abstract
Summary of Literature Review
Postlaminectomy kyphosis is uncommon and poorly understood, with controversy over the cause, risk factors, and treatment.
Material and Methods
We included 17 patients (8 male, 9 female) who had undergone multilevel laminectomy between 1982 to 2006. Their mean age at the time of laminectomy was 16.3 years. The locations of laminectomy were: 4 cervical/cervicothoracic,10 thoracic/thoracolumbar, and 3 lumbar. Possible factors for developing kyphotic deformities, such as an age at the time of laminectomy, sex, location, laminectomy extent, and radiation therapy were analyzed with the deformity angle and the time interval from the operation to the occurrence of deformity.
Results
The mean time after surgery was 18.3 months, and the mean kyphotic angle was 58 degrees. Patients younger than 12 years or surgery involving more than 4 segments had a slightly shorter time interval, but not significantly. Location had no significant correlation with angle and time interval. Radiation therapy and sex were not significant factors. Most (15) patients received corrective surgery 49.9 months after laminectomy, which reduced deformities to an average of 34.5 degrees, whereas 2 patients had mild curvatures of 38 degrees (mean) One patient received a second operation due to pullout of a rod, and one patient had a postoperative infection.
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Figures and Tables%
Fig. 1.
Postlaminectomy kyphosis in the skeletally immature achondroplast. (A) Radiograph immediate after laminectomy for symptomatic spinal stenosis. (B) Radiograph 7 months after laminectomy shows kyphotic deformity in lumbar spine. Kyphotic deformity can develop in most skeletally immature achondroplast including our case. (C) Radiograph after anterior and posterior fusion for postlaminectomy kyphosis.
Fig. 2.
Postlaminectomy cervical kyphosis. (A) Radiograph after laminectomy for removal of cavernous heman-gioma. (B) Radiograph 6 months after laminectomy shows progression of cervical kyphosis. (C) Radiograph after anterior fusion.
Table 1.
Average time interval from the operation to occurrence of kyphotic deformities after laminectomy.
Table 2.
Average angle of kyphotic deformities after laminectomy at the thoracic spine.
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