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PubMed · 9879099

Postlaminectomy kyphosis.

T J Albert·A Vacarro
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Abstract

Postlaminectomy kyphosis is a rare but potentially catastrophic complication of laminectomy performed to treat cervical myelopathy. The best strategy for prevention is awareness of the sagittal plane before surgery in patients with cervical spondylotic myelopathy. An understanding of the biomechanical forces placed on the cervical spine, the normal structures contributing to stability and the underlying pathologic process helps in the prevention and ultimate treatment of postlaminectomy kyphosis. This is a review of the risk factors, biomechanics, work-up, and surgical treatment of postlaminectomy kyphosis.

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Cervical VertebraeHumansKyphosisLaminectomyJournal ArticleReview

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BibTeXRIS

T J Albert, A Vacarro. 1998-12-15. Postlaminectomy kyphosis.. https://doi.org/10.1097/00007632-199812150-00014

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PubMed2007

Surgical treatment of cervical kyphosis in Larsen syndrome: report of 3 cases and review of the literature.

STUDY DESIGN: A retrospective case series. OBJECTIVE: To review the surgical results for midcervical kyphosis in 3 cases with Larsen syndrome, and to discuss the choice of surgical treatments. SUMMARY OF BACKGROUND DATA: Cervical kyphosis is the most hazardous and serious manifestation of Larsen syndrome due to the risk of life-threatening paralysis, and thus usually requires surgical treatment. However, little information has been reported concerning surgical treatments for this challenging condition. METHODS: Three patients with Larsen syndrome were surgically treated for midcervical kyphosis at our institution. RESULTS: An infant with mild cervical kyphosis was successfully treated with posterior arthrodesis using a halo immobilization, and anterior vertebral growth with a mature posterior fusion mass resulted in spontaneous correction of the kyphosis. In the remaining 2 infants with myelopathic symptoms due to severe and structural kyphosis, anterior decompression and fusion via a lateral approach followed by posterior fusion with segmental spinal instrumentation and halo immobilization resulted in improved neurologic symptoms and solid fusion. CONCLUSIONS: Posterior spinal fusion is only indicated for patients with mild and flexible cervical kyphosis, and anterior decompression and circumferential arthrodesis is required for patients with severe kyphotic deformity, who usually develop myelopathic symptoms. Anterior surgery for such a small patient with severe kyphosis involves much higher risk of spinal cord injury during decompression maneuvers and difficulty in stabilization of the reconstructed cervical spine. Therefore, all patients with Larsen syndrome should be screened with radiographs at the first visit to detect cervical kyphosis early so that posterior alone fusion is possible.

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