Surgical Decompression for Lumbar Stenosis in Pediatric Achondroplasia

Baca, Kirsten E.; Abdullah, Madeel A.; Ting, Beverlie L.; Schkrohowsky, Joshua G.; Hoernschemeyer, Daniel G.; Carson, Benjamin S.; Ain, Michael C.

doi:10.1097/bpo.0b013e3181e00c66

Cited by 20 publications

(21 citation statements)

References 11 publications

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“…Such an operation does not change the sagittal profile of the spine but reduces the risk of potential complications associated with the changes of its primary sagittal and frontal balance [16]. Although Baca et al recommend using instrumentation to stabilize the spine, it seems to us that this depends on the extent of the laminotomy performed and is not always necessary [17].…”

Section: Discussionmentioning

confidence: 99%

Surgical treatment of symptomatic vertebral canal stenosis in patients with achondroplasia – case report

Sienkiel¹,

Rehabilitation²,

Jasiewicz³

et al. 2018

Chir. Narzadow Ruchu Ortop. Pol.

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Authors report the history of two patients with achondroplasia, treated for symptomatic lumbar spinal stenosis. Both patients underwent cross-limb lengthening. During control visits they reported lumbar spine pain with increasing neurogenic claudication. In magnetic resonance imaging of the lumbar spine, we measured dural sac cross-sectional area (DSCSA) and spinal canal cross-sectional area (SCCSA) and the patients were qualified to the group of patients with critical spinal stenosis. They underwent "split" type laminotomy in the lumbar spine. In both patients, based on the Oswestry questionnaire, we noted very good result of surgical treatment. The most important change was increase of the walking distance after the procedure. In patients suffering from achondroplasia, with critical lumbar spinal canal stenosis and neurological symptoms the procedure of choice is surgical treatment. Surgical decompression of the spinal canal using "split" type laminotomy is an effective technique, preventing the destabilization of the posterior column and sagittal imbalance of the spine.

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Section: Discussionmentioning

confidence: 99%

Surgical treatment of symptomatic vertebral canal stenosis in patients with achondroplasia – case report

Sienkiel¹,

Rehabilitation²,

Jasiewicz³

et al. 2018

Chir. Narzadow Ruchu Ortop. Pol.

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“…Other clinical findings include increased angle between the lumbar spine and sacrum, thickened lamina, intervertebral disc widening, and scalloped posterior vertebra. These deformities increase the incidence of spinal cord compression and cauda equina [2][3][4][5][6][7][8]. Additionally, kyphosis may be present at the thoracolumbar junction, leading to vertebral bodies wedging and forming a "bulletshaped" vertebra cranially as the kyphosis progresses [1].…”

Section: Spinal Stenosismentioning

confidence: 99%

“…In 2006, Ain reported that 37% to 89% of achondroplastic patients have symptomatic spinal stenosis, but only 10% to 25% will require surgical treatment [8,11]. And in 2010, Baca et al reported that by adulthood, 20% to 30% of achondroplastic patients will have neurogenic symptoms (including paraplegia, bowel/bladder dysfunction, or walking intolerance) with 10% of them requiring surgical intervention [4].…”

Section: Spinal Stenosismentioning

confidence: 99%

Post-Laminectomy Kyphosis in Achondroplasia Patients: To Concurrently Fuse or Not

Hallan

Mrowczynski

McNutt

et al. 2020

Cureus

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The purpose of this review is to look at the incidence of post-laminectomy kyphosis in achondroplasia patients and to determine whether skeletal maturity and the number and location of laminectomies predict kyphosis in this patient population. Our review of the literature included all articles from MEDLINE/PubMed and Ovid from inception to 2019. After removing duplicates and checking for relevancy, the final number of articles yielded was eight. The results of this review summarize the incidence of postlaminectomy kyphosis in achondroplasia patients. In conclusion, we suggest fusion be considered in conjunction with multilevel laminectomies due to a high incidence of kyphosis with a need for stabilization in the pediatric achondroplastic patient population.

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“…Spinal canal decompression is one of the most common surgical strategies to treat spinal stenosis in patients with achondroplasia, and it can reduce symptoms of lumbar stenosis (6). However, the great risk of neurological injury has discouraged the use of this procedure.…”

Section: Surgical Therapymentioning

confidence: 99%

“…X-rays have clearly shown that achondroplastic patients exhibit developmental disorders including an underdeveloped skull base/ facial bones, small facial bones, an enlarged head, a prominent forehead, bullet-shaped vertebral bodies, shorter anteroposterior diameter of the spinal canals, thicker long bones as well as metaphyseal flaring (4,5). Additionally, a third of patients with achondroplasia may develop spinal stenosis and thoracolumbar kyphosis (6,7). Leg and lower back pain are reported in half of adult patients, revealing the first signs of spinal stenosis.…”

Section: Introductionmentioning

confidence: 99%