Spinal deformity following selective dorsal rhizotomy.
The authors performed a review of 79 patients treated by selective dorsal rhizotomy with laminoplasty, 78 of whom were ambulatory, to determine the prevalence of spinal deformities. The mean radiographic follow-up was 4.2 years, the mean clinical follow-up 5.8 years. Scoliosis (11 degrees -24 degrees ) was identified in 13 children, none of whom had a preexisting deformity. There were no significant differences between preoperative and follow-up thoracic kyphosis or lumbar lordosis, although there was a significant difference in lumbar lordosis between sitting and standing radiographs. No progressive or rigid hyperlordotic deformities were observed in the lumbar spine. Spondylolisthesis was identified in nine children (12%) (8/9 grade I), and one patient required an arthrodesis for pain. Spondylolisthesis was correlated with greater lumbar lordosis, stronger hip abductors, and increased popliteal femoral angles preoperatively, and with stronger hip flexors postoperatively. Back pain was identified in 4 of the 79 patients at last follow-up, 2 of whom had spondylolisthesis. As some cases of spondylolisthesis will remain asymptomatic, periodic radiographic follow-up is recommended.
Spiegel
David A
DA
Shriners Hospital for Children/Twin Cities, and University of Minnesota, Minneapolis, Minnesota 55414, USA. dspiegel@shrinenet.org
Loder
Randall T
RT
Alley
Katie A
KA
Rowley
Sarah
S
Gutknecht
Sarah
S
Smith-Wright
Deborah L
DL
Dunn
Mary Elizabeth
ME
D002547:Cerebral Palsy / Q000601:surgery; D005260:Female; D006621:Hip Joint / Q000503:physiopathology; D006801:Humans; D007719:Knee Joint / Q000503:physiopathology; D007738:Kyphosis / Q000209:etiology; D008141:Lordosis / Q000209:etiology; D008297:Male; D016059:Range of Motion, Articular; D012189:Retrospective Studies; D019051:Rhizotomy / Q000009:adverse effects*; D012600:Scoliosis / Q000209:etiology; D013121:Spinal Curvatures / Q000209:etiology*; D013168:Spondylolisthesis / Q000601:surgery