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Title of Journal: International Orthopaedics SICO

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Abbravation: International Orthopaedics

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Springer-Verlag

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10.1016/0304-4203(95)00096-8

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1432-5195

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Spinal deformity after multilevel osteoplastic lam

Authors: Peter Raab Krauss Juergen Harald Gloger Nils Soerensen Alexander Wild
Publish Date: 2007/02/24
Volume: 32, Issue: 3, Pages: 355-359
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Abstract

Multilevel laminectomy in children has a significant rate of postoperative spinal deformity To decrease the incidence of this complication the use of osteoplastic laminotomy is advocated to minimise the risk of spinal deformity by preserving the normal architecture of the spine In this retrospective study a 10year series of a paediatric population undergoing multilevel osteoplastic laminotomy is reviewed to determine the incidence especially in contrast to laminectomies and to identify factors that affect the occurrence of spinal column deformity Seventy patients mean age 42 years underwent multilevel osteoplastic laminotomy for congenital anomalies or removal of spinal tumours All patients had a clinical and radiographic examination preoperatively 12 months postoperatively and at followup Mean followup was 53 years range 3–126 years Nineteen patients 27 had a new or progressive spinal deformity There was an increased incidence in patients who had surgery for spinal tumours P  005 surgery of the cervical spine P  001 and who had more than five levels of the spine included P  005 A review of the literature on children with multilevel laminectomy n = 330 the incidence of spinal deformity found a significantly higher 46 compared to our study group This study demonstrates that osteoplastic laminotomy was found to be very effective in decreasing the incidence of spinal deformities after spinalcanal surgery for spinalcord tumours or congenital anomalies in children and adolescents The choice of an anatomical reconstructive surgical technique such as osteoplastic laminotomy seems to be essential to minimise secondary problems due to the surgical technique itself Nevertheless growing patients should be followed up for several years after the initial operation for early detection and consequent management of any possible deformity of the spinal columnLa laminectomie étagée chez l’enfant entraîne un taux important de déformations rachidiennes postopératoires Pour diminuer l’incidence de cette complication nous utilisons la laminotomie ostéoplastique qui sert à préserver une architecture normale du rachis Dans cette étude rétrospective une série d’enfants a été revue sur 10 ans de façon à déterminer l’incidence de ces déformations en comparaison avec la laminectomie 70 patients âge moyen 42 ans ont bénéficié d’une laminotomie ostéoplastique pour anomalie congénitale ou pour résection tumorale Les patients ont bénéficié d’un suivi clinique et radiographique le suivi moyen a été de 53 ans de 3 à 126 ans 19 patients 27 ont présenté une déformation progressive du rachis Celleci est plus importante dans les résections pour tumeurs P  005 et au niveau de la colonne cervicale P  001 et lorsque 5 niveaux ont été inclus sur le plan chirurgical P  005 La revue de la littérature à propos de 330 laminectomies a montré une incidence des déformations rachidiennes de 46 comparé au 27 de notre série Cette étude démontre que la laminotomie ostoplastique est une chirurgie qui diminue l’incidence des déformations rachidiennes après chirurgie pour malformation ou tumeur Néanmoins ces patients devront être surveillés pendant toute la période de croissance de façon à détecter une déformation éventuelle


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