[Postlaminectomy kyphosis of the cervical spine complicating spinal cord tumor in the foramen magnum].
Postlaminectomy kyphosis is rarely encountered as a sequela of decompression of the upper cervical spine, especially in adults. We present a case of disabling cervical kyphosis which developed after laminectomy for excision of a foramen magnum tumor and was treated successfully by occipito-vertebral fusion. A sixty-one-year old female was treated by laminectomy of the first through to the third cervical spine for a foramen magnum meningioma. One year later, the laminectomy was extended downward to include the fourth through to the seventh cervical spine because of neurological deterioration. Seven years after the first laminectomy, she was referred to our spinal service because of severe neck pain, numbness and muscle weakness of both upper extremities. Lateral X-ray of her cervical spine presented a severe kyphosis. Roentgenogram two months after the first laminectomy already showed slight deformity and, timewise, it corresponded with the time when the patient experienced neurological deterioration. Subsequent X-rays showed progression of kyphosis. After we confirmed a lessening of the pain and improvement of the neurological symptoms during an axial traction using a halo-vest, posterior occipito-cervico-thoracic fusion was performed using Luque segmental spinal instrumentation and autogenous bone graft. After surgery the pain decreased and neurological symptoms improved. It is important to be aware of the complication of kyphotic deformity after laminectomy and once it has developed, it is recommended to stabilize the progression by early spinal fusion.
Seki
K
K
Department of Orthopaedic Surgery, Faculty of Medicine, Kyoto University.
Shimizu
K
K
Matsushita
M
M
Li
Z L
ZL
Niibayashi
K
K
Yamamuro
T
T
D002574:Cervical Vertebrae; D005260:Female; D005539:Foramen Magnum; D006801:Humans; D007738:Kyphosis / Q000209:etiology / Q000601:surgery*; D007796:Laminectomy / Q000009:adverse effects*; D008579:Meningioma / Q000601:surgery*; D008875:Middle Aged; D013120:Spinal Cord Neoplasms / Q000601:surgery*; D013123:Spinal Fusion / Q000379:methods; D013131:Spine / Q000601:surgery