| Laminectomy in Patients With Achondroplasia: The Impact of Time to Surgery on Long-term Function. | |
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MedLine Citation:
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PMID: 20739914 Owner: NLM Status: In-Data-Review |
Abstract/OtherAbstract:
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STUDY DESIGN.: Retrospective analysis, survey. OBJECTIVE.: To describe a cohort of individuals with achondroplasia undergoing thoracolumbar laminectomy and to examine if shorter time to surgery was related to improvement in long-term functional outcome. SUMMARY OF BACKGROUND DATA.: Data on the long-term benefits of laminectomy are mixed for such patients. Earlier intervention may be associated with greater likelihood of long-term benefit, but quantified data are lacking. METHODS.: We retrospectively studied 49 patients with achondroplasia who underwent primary laminectomy for spinal stenosis. Patients completed a questionnaire to assess symptoms, walking distance, and independence (per Modified Rankin Scale), before surgery and currently. Responses were analyzed for the likelihood of improved walking distance or Rankin level. RESULTS.: Our patients had the following mean values: age, 37.7 ± 10.6 years; body mass index, 31.8 ± 5.5; symptom duration, 74.0 ± 100.1 months; preoperative symptom severity score, 2.7 ± 1.0 points; mean changes in blocks walked, +0.39 ± 2.0; and Rankin level, +0.08 ± 1.47. Patients with a time-to-surgery interval of <6 months were 7.13 times (95% confidence interval [CI], 1.39-36.66) more likely to experience improvement in walking distance and 4.00 times (95% CI, 1.05-15.21) more likely to experience Rankin level improvement than patients whose interval was >6 months. Intervals of up to 12 and 24 months were associated with increased likelihoods of 4.95 (95% CI, 1.41-17.41) and 3.43 (95% CI, 1.05-11.22), respectively, of improved walking distance compared with those with longer time-tosurgery intervals, but those Rankin level improvements were not statistically significant. CONCLUSION.: Time from symptom onset to surgery in patients with achondroplasia is an important predictor of long-term functional outcome. For sustained long-term postsurgical improvement, the window of opportunity might be relatively narrow. Patients with achondroplasia should seek medical advice for spinal stenotic symptoms as soon as possible. |
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Authors:
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Emily Streyer Carlisle; Beverlie L Ting; Madeel A Abdullah; Richard L Skolasky; Joshua G Schkrohowsky; Mary T Yost; Daniele Rigamonti; Michael C Ain |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Spine Volume: 36 ISSN: 1528-1159 ISO Abbreviation: Spine Publication Date: 2011 May |
Date Detail:
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Created Date: 2011-05-04 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 7610646 Medline TA: Spine (Phila Pa 1976) Country: United States |
Other Details:
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Languages: eng Pagination: 886-92 Citation Subset: IM |
Affiliation:
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From the Department of Orthopaedic Surgery, The Johns Hopkins University, Baltimore, MD. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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