“…This creates a potential bias, because presumably the patients with better outcomes (i.e., those with symptom resolution, normal wound healing, and no concern for complications) are those who would not otherwise follow up past their initial wound check evaluation. Given the obvious limitation in follow-up and available postoperative imaging studies, which precluded direct assessment of the development of spinal instability, spinal deformity, and chronic pain, we focused on the assessment of PSM fat infiltration and muscle atrophy, 5,[8][9][10][11][12] as this has been linked to the incidence of chronic back pain and is believed to predispose to spinal instability and progressive dysfunction. 9,10,12 Postlaminectomy spinal deformity is more prevalent in the pediatric population than in adults.…”