Spinal deformity after multiple-level cervical laminectomy in children.
Considerable controversy exists in the orthopedic and neurosurgical literature over the true incidence and nature of spinal deformity after multiple-level cervical laminectomy in children. Eighty-nine patients with a mean radiographic follow up of 5.1 years (range 2-9 years) were reviewed. Mean age at surgery was 5.7 years (range 1 month-18 years). Most common diagnoses were Arnold-Chiari malformation, syringomyelia, or both (81%). Significant deformity developed in 46 patients (53%), with 33 developing a mean kyphosis of 30 degrees (range 5-105 degrees) and 13 developing a mean hyperlordosis of 62 degrees (range 40-95 degrees). Peak age at surgery of 10.5 years correlated weakly (P = 0.08) with the development of kyphosis. The development of hyperlordosis was strongly correlated (P = 0.01) with a peak age at surgery of 4.2 years. There was no correlation between diagnosis, sex, location, or number of levels decompressed and the subsequent development of deformity.
Bell
D F
DF
Division of Orthopaedic Surgery, Hospital for Sick Children, Toronto, Ontario, Canada.
Walker
J L
JL
O'Connor
G
G
Tibshirani
R
R
D000293:Adolescent; D001139:Arnold-Chiari Malformation / Q000150:complications / Q000601:surgery; D002574:Cervical Vertebrae / Q000601:surgery*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007738:Kyphosis / Q000209:etiology; D007796:Laminectomy; D008141:Lordosis / Q000209:etiology; D008297:Male; D011183:Postoperative Complications; D011859:Radiography; D012044:Regression Analysis; D012189:Retrospective Studies; D013131:Spine / Q000000981:diagnostic imaging*; D013595:Syringomyelia / Q000150:complications / Q000601:surgery