Multiple short-segment laminoplasties in children: a novel technique to avoid postoperative spinal deformity.
BACKGROUND
Spinal deformity is a recognized important complication after laminectomies, especially in children. Even with laminoplasties, spinal deformity is a concern, especially when laminoplasties involve multiple levels. The author reports a novel technique to avoid postoperative spinal deformity using multiple short-segment replacement laminoplasties to access pathology over a long segment of the intraspinal space.


METHODS
The technique was used to evacuate an organized extradural hematoma from C4 to T9 in a 9-month-old infant with incomplete quadriplegia. Three separate, short-segment, and superiorly reflected laminoplasties (C5-C7; T2-T4; T6-T8) were performed, leaving intact the laminae (T1; T5) between each laminoplasty flap. At 1 year postoperatively, there was complete neurological recovery and no spinal deformity. The laminae re-fused anatomically.


CONCLUSIONS
Multiple short-segment laminoplasties allow good access to a long intraspinal segment, may preserve the stability of the spine, prevent spinal deformity, allow good reconstitution of the laminar anatomy, and facilitate surgical stabilization should that be required in the future. This technique may be applicable to other intraspinal lesions, such as tumors.
Division of Pediatric Neurosurgery, Department of Pediatric Surgery, British Columbia's Children's Hospital, Children's and Women's Health Center, 4480 Oak St, #K3-159, Vancouver, BC V6H 3V4, Canada. psteinbok@cw.bc.ca
Paul
P
Steinbok
D004388:Dura Mater / Q000473:pathology / Q000601:surgery; D005500:Follow-Up Studies; D006406:Hematoma / Q000209:etiology / Q000601:surgery*; D006467:Hemophilia A / Q000150:complications*; D006801:Humans; D007223:Infant; D007796:Laminectomy / Q000009:adverse effects / Q000379:methods*; D008297:Male; D013122:Spinal Diseases / Q000209:etiology / Q000517:prevention & control*; D013131:Spine / Q000601:surgery*; D016896:Treatment Outcome