Document Detail


Spinal column deformity and instability after lumbar or thoracolumbar laminectomy for intraspinal tumors in children and young adults.
MedLine Citation:
PMID:  9055374     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
STUDY DESIGN: A retrospective study about the occurrence of spinal column deformity or instability after multilevel lumbar or thoracolumbar total laminectomy for removal of benign intraspinal tumors in children and young adults. OBJECTIVES: To analyze the long-term clinical and radiographic outcome of these patients, and to specify factors that affect the occurrence of postlaminectomy spinal column deformity and instability. SUMMARY OF BACKGROUND DATA: Spinal column deformity is not uncommon after multilevel cervical or thoracic laminectomies for removal of intraspinal tumors in children. Its incidence in the lumbar and thoracolumbar spine reportedly is low. METHODS: Thirty-six consecutive patients (23 male, 13 female) underwent multilevel lumbar or thoracolumbar total laminectomy for removal of benign intraspinal tumors from 1966 to 1989. Twelve patients were aged 17 years or younger ("children and adolescents"; mean age, 11 years), and 24 were aged 18-30 years ("young adults"; mean age, 24 years). All patients had preoperative, immediate postoperative, and follow-up clinical and radiographic examinations. RESULTS: At a mean follow-up period of 14 years (range, 4-28 years), six patients (16.6%) had spinal deformity (lordosis or thoracolumbar kyphosis associated with scoliosis), and four (11%) had spondylolisthesis. Spinal column deformity occurred in 33% of children and adolescents and in 8% of young adults. Spondylolisthesis occurred in 16.6% of children and adolescents and in 8% of young adults. Three patients had fusion for spinal column deformity. Pain was present in eight patients, and other neurologic signs and symptoms were found in 18. There was an increased incidence of postoperative spinal deformity in patients who had more than two laminae removed (P < 0.01) or a facetectomy performed at the time of the initial operation (P < 0.05). There was no association between the occurrence of the deformity and sex, neurologic condition after laminectomy, or length of follow-up period. CONCLUSIONS: Spinal deformity or instability after multilevel lumbar or thoracolumbar total laminectomy is not uncommon in children and adolescents. Limiting laminae removal and facet destruction may decrease this incidence. Fusion may be required to correct post-laminectomy deformity and to stabilize the spine.
Authors:
P J Papagelopoulos; H A Peterson; M J Ebersold; P R Emmanuel; S N Choudhury; L M Quast
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Spine     Volume:  22     ISSN:  0362-2436     ISO Abbreviation:  Spine     Publication Date:  1997 Feb 
Date Detail:
Created Date:  1997-05-23     Completed Date:  1997-05-23     Revised Date:  2009-07-09    
Medline Journal Info:
Nlm Unique ID:  7610646     Medline TA:  Spine (Phila Pa 1976)     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  442-51     Citation Subset:  IM    
Affiliation:
Department of Orthopedics, Mayo Clinic, Rochester, Minnesota, USA.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Child
Female
Humans
Joint Instability / etiology
Laminectomy*
Lumbar Vertebrae / surgery*
Male
Postoperative Complications*
Reoperation
Spinal Diseases / etiology
Spinal Neoplasms / surgery*
Spine / radiography*,  surgery
Thoracic Vertebrae / surgery*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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