Yasuoka and colleagues measured how often spinal deformity followed multilevel laminectomy in patients under 25, and whether age and level mattered.
Mayo Clinic retrospective review of 58 patients under 25 who had multilevel laminectomy from 1965 to 1974 for conditions that do not themselves deform the spine.
Key Findings
Deformity developed in 12 of 26 patients (46%) under 15 but in only 2 of 32 (6%) aged 15 to 24.
Eight of the 12 younger patients with deformity needed anterior fusion. The 2 older patients had mild deformities that stopped progressing at maturity and needed no fusion.
Under age 15, deformity followed all 9 cervical or cervicothoracic laminectomies, 4 of 11 thoracic and none of 6 lumbar. Seven thoracic and 3 lumbar patients had no follow‑up films.
Anterior vertebral body wedging was the commonest pattern (7 of 12) and gave more severe kyphosis than hypermobility between bodies (3 of 12).
Deformity did not correlate with sex, number of laminae removed, neurological status or time since surgery. The authors note each subgroup was too small to show a correlation.
First radiographic signs appeared 2 to 74 months after laminectomy. Excluding trauma and facetectomy, no adult over 25 developed deformity needing fusion.
Board pearl
Deformity in children can first appear years after laminectomy. The authors advise radiographs for at least 6 years after cervical or thoracic multilevel laminectomy in children.
Authors' conclusion
The incidence of spinal deformity after multilevel laminectomy (excluding cases involving facetectomy and conditions that might, in themselves, cause deformity) is related to age of the patient and level of the laminectomy. The younger the patient, the more likely the occurrence.
Yasuoka and colleagues measured how often spinal deformity followed multilevel laminectomy in patients under 25, and whether age and level mattered.
Mayo Clinic retrospective review of 58 patients under 25 who had multilevel laminectomy from 1965 to 1974 for conditions that do not themselves deform the spine.
Key Findings
Deformity developed in 12 of 26 patients (46%) under 15 but in only 2 of 32 (6%) aged 15 to 24.
Eight of the 12 younger patients with deformity needed anterior fusion. The 2 older patients had mild deformities that stopped progressing at maturity and needed no fusion.
Under age 15, deformity followed all 9 cervical or cervicothoracic laminectomies, 4 of 11 thoracic and none of 6 lumbar. Seven thoracic and 3 lumbar patients had no follow‑up films.
Anterior vertebral body wedging was the commonest pattern (7 of 12) and gave more severe kyphosis than hypermobility between bodies (3 of 12).
Deformity did not correlate with sex, number of laminae removed, neurological status or time since surgery. The authors note each subgroup was too small to show a correlation.
First radiographic signs appeared 2 to 74 months after laminectomy. Excluding trauma and facetectomy, no adult over 25 developed deformity needing fusion.
Board pearl
Deformity in children can first appear years after laminectomy. The authors advise radiographs for at least 6 years after cervical or thoracic multilevel laminectomy in children.
Authors' conclusion
The incidence of spinal deformity after multilevel laminectomy (excluding cases involving facetectomy and conditions that might, in themselves, cause deformity) is related to age of the patient and level of the laminectomy. The younger the patient, the more likely the occurrence.