Post laminoplasty cervical kyphosis—Case report

D, De Santis; Mancarella, Cristina; Landi, Alessandro; Tarantino, Roberto; Ruggeri, Andrea; Delfini, Roberto

doi:10.1016/j.ijscr.2014.09.020

Cited by 12 publications

(4 citation statements)

References 15 publications

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“…[2,23] In the past years, it was suggested that hemi-laminectomy or laminotomy with laminoplasty might reduce this complication; results are, however, still controversial. [2,11,14,21,23] In our case, the need for an emergency treatment, combined to the difficulty in "dominating" intraoperative bleeding, led us to "adopt" cervicothoracic "complete" laminectomy, excluding other treatment modalities. Timing of surgery was reported only for two cases.…”

Section: No Other Information Availablementioning

confidence: 85%

Extradural hemorrhagic spinal cavernous angioma in a paucisymptomatic child: A rare case with review of the current literature

Scafa¹,

Giugliano²,

Gallo³

et al. 2022

Surgical Neurology International

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Background: Cavernous angiomas, also referred to as cavernous hemangiomas or cavernomas (CMs), are vascular malformative benign neoplasms that may develop in any part of the central nervous system. Spinal CMs are uncommon (overall incidence rate of 0.04–0.05%). Pure epidural CMs account for 1–2% of all spinal CMs and 4% of all spinal epidural tumors. Diagnosis is extremely rare in the pediatric age. To the best of our knowledge, only 10 cases have been described so far. The treatment of choice is microsurgical resection. Case Description: We describe here the rare case of a cervicothoracic hemorrhagic spinal epidural cavernoma in a paucisymptomatic, 8-year-old female Bangladeshi child. C7–T2 laminectomy with excision of a scarcely defined, capsulated dark red lesion was performed with good recovery. Conclusion: Spinal epidural cavernomas are rare. Childhood presentation is even rarer. The reason could be found in a greater “compliance” and to a rarer occurrence of acute bleeding in children, thus resulting in a delayed diagnosis. Surgical excision is the gold standard of treatment.

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Section: No Other Information Availablementioning

confidence: 85%

Extradural hemorrhagic spinal cavernous angioma in a paucisymptomatic child: A rare case with review of the current literature

Scafa¹,

Giugliano²,

Gallo³

et al. 2022

Surgical Neurology International

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“…This can result in a poor horizontal gaze, swallowing and respiratory issues, neck pain, and potential neurological compromise. 9 An anterior approach is often necessary to decompress the spine, realign the cervical vertebrate with hardware insertion, and restore neurological function. 10 In order to ensure the structural integrity of any anterior instrumentation, the use of posterior stabilization has been reported to have better maintenance of sagittal alignment, a higher rate of fusion, and a lower incidence of associated morbidities such as instrument subsidence or adjacent-level disease.…”

Section: Discussionmentioning

confidence: 99%

Pedicle subtraction metallectomy with complex posterior reconstruction for fixed cervicothoracic kyphosis: illustrative case

Chopra

Orenday-Barraza

Braley³

et al. 2023

Journal of Neurosurgery: Case Lessons

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BACKGROUND Iatrogenic cervical deformity is a devastating complication that can result from a well-intended operation but a poor understanding of the individual biomechanics of a patient’s spine. Patient factors, such as bone fragility, high T1 slope, and undiagnosed myopathies often play a role in perpetuating a deformity despite an otherwise successful surgery. This imbalance can lead to significant morbidity and a decreased quality of life. OBSERVATIONS A 55-year-old male presented to the authors’ clinic with a chin-to-chest deformity and cervical myelopathy. He previously had an anterior C2–T2 fixation and a posterior C1–T6 instrumented fusion. He subsequently developed screw pullout at multiple levels, so the original surgeon removed all of the posterior hardware. The T1 cage (original corpectomy) severely subsided into the body of T2, generating an angular kyphosis that eventually developed a rigid osseous circumferential union at the cervicothoracic junction with severe cord compression. An anterior approach was not feasible; therefore, a 3-column osteotomy/fusion in the upper thoracic spine was planned whereby 1 of the T2 screws would need to be removed from a posterior approach for the reduction to take place. LESSONS This case highlights the devastating effect of a hardware complication leading to a fixed cervical spine deformity and the complex decision making involved to safely correct the challenging deformity and restore function.

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“…After the introduction of the laminoplasty, many studies reported postoperative kyphotic changes to the cervical spine 2 , 3) . The results of the present study suggest that postoperative cervical spinal deformity is related to poor clinical outcomes.…”

Section: Discussionmentioning

confidence: 99%

The Predictable Factors of the Postoperative Kyphotic Change of Sagittal Alignment of the Cervical Spine after the Laminoplasty

Lee

Son

Lee

et al. 2017

J Korean Neurosurg Soc

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ObjectiveLaminoplasty is an effective surgical method for treating cervical degenerative disease. However, postoperative complications such as kyphosis, restriction of neck motion, and instability are often reported. Despite sufficient preoperative lordosis, this procedure often aggravates the lordotic curve of the cervical spine and straightens cervical alignment. Hence, it is important to examine preoperative risk factors associated with postoperative kyphotic alignment changes. Our study aimed to investigate preoperative radiologic parameters associated with kyphotic deformity post laminoplasty.MethodsWe retrospectively reviewed the medical records of 49 patients who underwent open door laminoplasty for cervical spondylotic myelopathy (CSM) or ossification of the posterior longitudinal ligament (OPLL) at Pusan National University Yangsan Hospital between January 2011 and December 2015. Inclusion criteria were as follows: 1) preoperative diagnosis of OPLL or CSM, 2) no previous history of cervical spinal surgery, cervical trauma, tumor, or infection, 3) minimum of one-year follow-up post laminoplasty with proper radiologic examinations performed in outpatient clinics, and 4) cases showing C7 and T1 vertebral body in the preoperative cervical sagittal plane. The radiologic parameters examined included C2–C7 Cobb angles, T1 slope, C2–C7 sagittal vertical axis (SVA), range of motion (ROM) from C2–C7, segmental instability, and T2 signal change observed on magnetic resonance imaging (MRI). Clinical factors examined included preoperative modified Japanese Orthopedic Association scores, disease classification, duration of symptoms, and the range of operation levels.ResultsMean preoperative sagittal alignment was 13.01° lordotic; 6.94° lordotic postoperatively. Percentage of postoperative kyphosis was 80%. Patients were subdivided into two groups according to postoperative Cobb angle change; a control group (n=22) and kyphotic group (n=27). The kyphotic group consisted of patients with more than 5° kyphotic angle change postoperatively. There were no differences in age, sex, C2–C7 Cobb angle, T1 slope, C2–C7 SVA, ROM from C2–C7, segmental instability, or T2 signal change. Multiple regression analysis revealed T1 slope had a strong relationship with postoperative cervical kyphosis. Likewise, correlation analysis revealed there was a statistical significance between T1 slope and postoperative Cobb angle change (p=0.035), and that there was a statistically significant relationship between T1 slope and C2–C7 SVA (p=0.001). Patients with higher preoperative T1 slope demonstrated loss of lordotic curvature postoperatively.ConclusionLaminoplasty has a high probability of aggravating sagittal balance of the cervical spine. T1 slope is a good predictor of postoperative kyphotic changes of the cervical spine. Similarly, T1 slope is strongly correlated with C2–C7 SVA.

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Post laminoplasty cervical kyphosis—Case report

Cited by 12 publications

References 15 publications

Extradural hemorrhagic spinal cavernous angioma in a paucisymptomatic child: A rare case with review of the current literature

Extradural hemorrhagic spinal cavernous angioma in a paucisymptomatic child: A rare case with review of the current literature

Pedicle subtraction metallectomy with complex posterior reconstruction for fixed cervicothoracic kyphosis: illustrative case

The Predictable Factors of the Postoperative Kyphotic Change of Sagittal Alignment of the Cervical Spine after the Laminoplasty

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