Post-laminectomy deformities

Lutz, Fabiano Stumpf; Rocha, Luis Eduardo Munhoz da

doi:10.1590/s1808-18512014130400362

Cited by 3 publications

(5 citation statements)

References 6 publications

(5 reference statements)

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“…It has been stated that postoperative immobilization will not prevent the appearance of deformity, but may delay the deformity (5).…”

Section: Resultsmentioning

confidence: 99%

Postlaminectomy instability–is fusion essential in degenerative lumbar stenosis surgery?

Gürsoy

2022

Journal of Health Sciences and Medicine

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Aim: To examine the incidence of postlaminectomy instability in cases of lumbar spinal stenosis who underwent facet-preserving laminectomy and decompression with the classical laminectomy technique, together with comorbid diseases, and to determine whether fusion is needed. Material and Method: The patients who were operated by the same surgeon in the same hospital between 2017 and 2019 and followed up in terms of instability in the postoperative 1st and 6th months were evaluated retrospectively with their clinical findings, comorbid diseases and radiological images. White and Panjabi's instability criteria were used. It was analyzed with SPSS 23.00 statistical package program. Data were analyzed by descriptive statistics (number, percentage distribution, mean and standard deviation), t-test and ANOVA. Results: A total of 53 patients, 22 male (41.5%) and 31 female (58.5%) were included in the study. Age, surgical precedures and comorbid diseases were investigated. None of the patients, but 2 patients with osteoporosis with or without diabets, had postlaminectomy instability. Conclusion: It has been shown in our study that decompressive and facet-preserving surgery performed at 2 levels or less using only the classical laminectomy technique does not cause instability in patients without osteoporosis alone or with diabetes, especially in the first 6 months, and can be safely applied to patients. Osteoporosis alone or in association with diabetes mellitus suggests increased postoperative instability.

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“…It has been stated that postoperative immobilization will not prevent the appearance of deformity, but may delay the deformity (5).…”

Section: Resultsmentioning

confidence: 99%

Postlaminectomy instability–is fusion essential in degenerative lumbar stenosis surgery?

Gürsoy

2022

Journal of Health Sciences and Medicine

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“…Postlaminectomy deformity when severe may cause neural compression which in turn would lead to neurological symptoms. [6] Robert and Bortolussi postulated that as the deformity progresses, the weight-bearing pivot of the body moves anteriorly and therefore can only be amended with spinal column sagittal balance reconstruction. [7] Some theories propose that radiation and posterior muscle inadequacy leading to arrest in vertebral growth are the primary reasons of deformity postlaminectomy.…”

Section: Discussionmentioning

confidence: 99%

“…[10] Delay in the development of kyphotic deformity can be achieved by immobilization after surgery; however, it does not appear to prevent it. [6] Surgical intervention is indicated in the severity and progression of the deformity and related neurological deficits. [9] Lutz and Munhoz da Rocha reported that the time between surgery and postsurgery kyphosis was 4 years and 3 months.…”

Section: Discussionmentioning

confidence: 99%

Correction of postlaminectomy cervical kyphosis in an operated case of cervical spine primitive neuroectodermal tumor

et al. 2019

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A 14-year-old boy presented with gradually worsening spastic quadriparesis and cervical kyphotic deformity as a consequence of laminectomy for tumor debulking and chemoradiotherapy done 2 years prior for cervical primitive neuroectodermal tumor. Problems to be addressed particularly to the case were a rigid kyphosis of 102.7°, poor soft-tissue coverage, internal gibbus compressing cord, perched facets, and superficial location of cord. The surgery was staged, in that the first anterior release was done with gradually increasing traction to correct the kyphosis progressively. Posterior instrumentation was done in the second stage. Finally, anterior reconstruction with tricortical iliac bone grafting was done. The patient regained full power with complete union at the end of 18 months. Irradiation of tumor along with laminectomy results in loss of posterior tension band which results in progressive kyphotic deformity in children. A staged plan of surgical interventions can help in postoperative correction of deformity with circumferential union and prevention of recurrence. This article describes successful treatment of a patient with postlaminectomy cervical kyphosis with 77° of correction achieved postoperatively and also highlights the importance of anterior and posterior reconstructions to achieve a stable vertebral column.

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“…This may or may not be related to the failure of support of the anterior portion of the spinal column. In its severe form, post-laminectomy deformity may cause neurologic symptoms due to neural compression (1). Bartolussi hypothesized that as the deformity progresses the weight tolerating pivot of the body moves anteriorly and thus can only be corrected with spinal column sagittal balance reconstruction (4).…”

Section: Discussionmentioning

confidence: 99%

“…Spinal kyphotic deformity after spinal laminectomy and laminoplasty is uncommon in adults but often occurs in the pediatric population; it has been reported that spinal deformity occurs in 26% of newborn infants and children after laminectomy (1,2). Lonstein proposed that kyphotic deformity can be attributed to the decrease in cartilage growth and anterior wedging associated with laminectomies in which the cartilage endplates of the vertebral bodies experience increased pressure in the anterior direction (3).…”

Section: Introductionmentioning

confidence: 99%

Kyphotic deformity after laminectomy surgery for a gunshot wound to the spine: a case report

Babashahi¹,

Taheri²

2016

J. Spine Surg.

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Spinal kyphotic deformity after spinal laminectomy or laminoplasty is more common in pediatric patients than adults. Laminectomy can lead to decreased cartilage growth, anterior wedging and posterior spinal muscle insufficiency which can result in kyphotic deformity. Herein we outline a case report of a child presenting with kyphotic deformity after receiving a spinal laminectomy to treat a penetrating spinal trauma. The 8-year-old male presented with penetrating spinal trauma following a gunshot wound and subsequently underwent L1 laminectomy and thecal sac decompression to remove the foreign body. In a follow-up examination approximately one month after surgery, imaging revealed kyphotic deformity and the patient was referred to the Rasoul-e-Akram Hospital. The patient then underwent surgical reconstruction.The postoperative computed tomography (CT) scan showed appropriate repair of sagittal balance and the patient's symptoms gradually improved. Post-laminectomy kyphosis is a notable concern and complication in the pediatric population and can occur shortly after surgery. The following interventions can decrease the likelihood of post-laminectomy kyphosis: minimal muscle dissection and bone removal during laminectomy, avoidance of facet disruption, use of laminoplasty rather than laminectomy, postoperative immobilization/ bracing and regular follow-up for early detection and treatment of any deformity. Case Report IntroductionSpinal kyphotic deformity after spinal laminectomy and laminoplasty is uncommon in adults but often occurs in the pediatric population; it has been reported that spinal deformity occurs in 26% of newborn infants and children after laminectomy (1,2). Lonstein proposed that kyphotic deformity can be attributed to the decrease in cartilage growth and anterior wedging associated with laminectomies in which the cartilage endplates of the vertebral bodies experience increased pressure in the anterior direction (3). Moreover, posterior spinal muscle insufficiency following laminectomy can result in the progression of the kyphotic deformity (2).Herein we present a case report of a child who showed post-laminectomy kyphotic deformity after undergoing laminectomy to treat penetrating spinal trauma. Case presentationAn 8-year-old male admitted to Rasoul-e-Akram Hospital presented with a penetrating spinal injury due to a gunshot wound to the thoracolumbar region. The patient had no past medical history. The patient underwent L1 bilateral laminectomy, facetectomy, thecal sac decompression and removal of foreign bodies. After surgery, he experienced severe lower limb paraparesis and sphincter control deficit. In a follow-up visit he demonstrated only minimal improvement in neurologic condition and displayed sagittal balance kyphotic deformity. The plain radiography and computed tomography (CT) scan revealed kyphotic deformity associated with L1 laminectomy (Figure 1). Because of progression of the kyphotic deformity and persistence of the neurologic deficits, he was referred to the care of the authors...

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Post-laminectomy deformities

Cited by 3 publications

References 6 publications

Postlaminectomy instability–is fusion essential in degenerative lumbar stenosis surgery?

Postlaminectomy instability–is fusion essential in degenerative lumbar stenosis surgery?

Correction of postlaminectomy cervical kyphosis in an operated case of cervical spine primitive neuroectodermal tumor

Kyphotic deformity after laminectomy surgery for a gunshot wound to the spine: a case report

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