The Kyphotic Deformity After Multi-level Laminectomy / 대한척추외과학회지

ABSTRACT

STUDY DESIGN: A Retrospective study OBJECTIVES: To analyze the characteristics, risk factors, and outcomes of postlaminectomy kyphosis. SUMMARY OF LITERATURE REVIEW: Postlaminectomy kyphosis is uncommon and poorly understood, with controversy over the cause, risk factors, and treatment. MATERIAL AND METHODS: We included 17 patients (8 male, 9 female) who had undergone multilevel laminectomy between 1982 to 2006. Their mean age at the time of laminectomy was 16.3 years. The locations of laminectomy were: 4 cervical/cervicothoracic, 10 thoracic/thoracolumbar, and 3 lumbar. Possible factors for developing kyphotic deformities, such as an age at the time of laminectomy, sex, location, laminectomy extent, and radiation therapy were analyzed with the deformity angle and the time interval from the operation to the occurrence of deformity. RESULTS: The mean time after surgery was 18.3 months, and the mean kyphotic angle was 58 degrees. Patients younger than 12 years or surgery involving more than 4 segments had a slightly shorter time interval, but not significantly. Location had no significant correlation with angle and time interval. Radiation therapy and sex were not significant factors. Most (15) patients received corrective surgery 49.9 months after laminectomy, which reduced deformities to an average of 34.5 degrees, whereas 2 patients had mild curvatures of 38 degrees (mean) One patient received a second operation due to pull-out of a rod, and one patient had a postoperative infection. CONCLUSION: Postlaminectomy kyphosis attends to occur earlier in younger patients and patients with a large number of laminas resected, so careful observation should be done for early detection and management.