Spinal Deformity Following Selective Dorsal Rhizotomy

Spiegel, David A.; Loder, Randall T.; Alley, Katie A.; Rowley, Sarah; Gutknecht, Sarah; Smith-Wright, Deborah L.; Dunn, Mary Elizabeth

doi:10.1097/01241398-200401000-00007

Cited by 49 publications

(3 citation statements)

References 24 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The other is laminotomy limited to one to three level(s), exposing the conus medullaris/cauda equina at the thoracolumbar junction. The first mode requires longer postoperative immobilization and entails a higher risk of secondary instability and kyphosis [14,18,31,32,41,42,47,48]. With the second mode, which is at present the most popular and less invasive approach, especially if limited to a single level laminectomy/laminotomy, identification of root levels and corresponding functions-which may vary among individuals-is more difficult, and intraoperative electrostimulation less accurate [38].…”

Section: Introductionmentioning

confidence: 99%

Keyhole interlaminar dorsal rhizotomy for spastic diplegia in cerebral palsy

Sindou

Georgoulis

2015

Acta Neurochir

View full text Add to dashboard Cite

show abstract

Section: Introductionmentioning

confidence: 99%

Keyhole interlaminar dorsal rhizotomy for spastic diplegia in cerebral palsy

Sindou

Georgoulis

2015

Acta Neurochir

View full text Add to dashboard Cite

show abstract

“…9,13,37,39,51 Some have suggested that postlaminectomy deformity can be minimized by use of laminoplasty, but there is little convincing data to support this practice. 9,25,30,33,46,51 Our small sample size prevented a detailed analysis, but of the patients included in this study, 70% underwent laminectomy compared with 30% who had laminoplasty. The 1 patient who developed postoperative deformity underwent T3-L3 laminotomies.…”

Section: 238mentioning

confidence: 99%

Surgical outcomes in spinal cord ependymomas and the importance of extent of resection in children and young adults

Safaee¹,

Mummaneni

et al. 2014

PED

View full text Add to dashboard Cite

Object Ependymomas are a common type of CNS tumor in children, although only 13% originate from the spinal cord. Aside from location and extent of resection, the factors that affect outcome are not well understood. Methods The authors performed a search of an institutional neuropathology database to identify all patients with spinal cord ependymomas treated over the past 20 years. Data on patient age, sex, clinical presentation, symptom duration, tumor location, extent of resection, use of radiation therapy, surgical complications, presence of tumor recurrence, duration of follow-up, and residual symptoms were collected. Pediatric patients were defined as those 21 years of age or younger at diagnosis. The extent of resection was defined by the findings of the postoperative MR images. Results A total of 24 pediatric patients with spinal cord ependymomas were identified with the following pathological subtypes: 14 classic (Grade II), 8 myxopapillary (Grade I), and 2 anaplastic (Grade III) ependymomas. Both anaplastic ependymomas originated in the intracranial compartment and spread to the spinal cord at recurrence. The mean follow-up duration for patients with classic and myxopapillary ependymomas was 63 and 45 months, respectively. Seven patients with classic ependymomas underwent gross-total resection (GTR), while 4 received subtotal resection (STR), 2 received STR as well as radiation therapy, and 1 received radiation therapy alone. All but 1 patient with myxopapillary ependymomas underwent GTR. Three recurrences were identified in the Grade II group at 45, 48, and 228 months. A single recurrence was identified in the Grade I group at 71 months. The mean progression-free survival (PFS) was 58 months in the Grade II group and 45 months in the Grade I group. Conclusions Extent of resection is an important prognostic factor in all pediatric spinal cord ependymomas, particularly Grade II ependymomas. These data suggest that achieving GTR is more difficult in the upper spinal cord, making tumor location another important factor. Although classified as Grade I lesions, myxopapillary ependymomas had similar outcomes when compared with classic (Grade II) ependymomas, particularly with respect to PFS. Long-term complications or new neurological deficits were rare. Among patients with long-term follow-up, those who underwent GTR had a recurrence rate of 20% compared with 40% among those with STR or biopsy only, suggesting that extent of resection is perhaps a more important prognostic factor than histological grade in predicting PFS, which has been suggested by other data in the literature. Given the relative paucity of these lesions, collaborative multiinstitutional studies are needed, and such efforts should also focus on molecular and genetic analysis to refine the current classification system.

show abstract

“…Investigators reporting biomechanical studies conducted in the laboratory have suggested that laminoplasty may produce less instability, but clinical studies provide only marginal data supporting this practice. 8,22,25,38,45 For patients with a preexisting spinal deformity, fusion should be considered at the time of tumor resection to prevent postoperative progression of the deformity. No firm guidelines have been developed for this practice of prophylactic fusion to prevent progression of deformity, but we would consider all risk factors and counsel the patient accordingly.…”

Section: Measures To Reduce Risk Of Postlaminectomy Deformitymentioning

confidence: 99%

Cervical spine deformity associated with resection of spinal cord tumors

Fassett

Clark

Brockmeyer

et al. 2006

FOC

View full text Add to dashboard Cite

✓ Postoperative sagittal-plane cervical spine deformities are a concern when laminectomy is performed for tumor resection in the spinal cord. These deformities appear to occur more commonly after resection of intramedullary spinal cord lesions, compared with laminectomy for stenosis caused by degenerative spinal conditions. Postlaminectomy deformities are most common in pediatric patients with an immature skeletal system, but are also more common in young adults (< 25 years of age) in comparison with older adults. The extent of laminectomy and facetectomy, number of laminae removed, location of laminectomy, preoperative loss of lordosis, and postoperative radiation therapy in the spine have all been reported to influence the risk of postlaminectomy spinal deformities. When these occur, patients should be monitored closely with serial imaging studies, because a significant percentage will have progressive deformities. These can range from focal kyphosis to more complicated swan-neck deformities. General indications for surgical intervention include progressive deformity, axial pain in the area, and neurological symptoms attributable to the deformity. Surgical options include anterior, posterior, and combined anterior–posterior procedures. The authors have reviewed the literature on postlaminectomy kyphosis as it relates to resection of cervical spinal cord tumors, and they summarize some general factors to consider when treating these patients.

show abstract

Spinal Deformity Following Selective Dorsal Rhizotomy

Cited by 49 publications

References 24 publications

Keyhole interlaminar dorsal rhizotomy for spastic diplegia in cerebral palsy

Keyhole interlaminar dorsal rhizotomy for spastic diplegia in cerebral palsy

Surgical outcomes in spinal cord ependymomas and the importance of extent of resection in children and young adults

Cervical spine deformity associated with resection of spinal cord tumors

Contact Info

Product

Resources

About