John A. Heydemann, MD; Oussama Abousamra, MD;

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Presentation transcript:

Spinal Surgery in Achondroplasia: Outcome Analysis and Risk Factors for Impending Neurologic Deficit John A. Heydemann, MD; Oussama Abousamra, MD; Tyler Kreitz, MD; Kenneth J. Rogers, PhD; Colleen Ditro, DNP, CPNP; Suken A. Shah, MD; William G. Mackenzie, MD

Background • Thoracolumbar kyphosis (TLK) often resolves • Occasionally curve progresses • Spinal stenosis treated with laminectomy and fusion

Methods • Surgery for symptomatic stenosis due to TLK • Compared to: Within surgical group Non-surgical matched group

Surgical group 26 children p values Preop Postop LFU Preop vs. Postop Postop vs. LFU Mean SD Thoracic Kyphosis 14 24 28 16 30 17 0.025 0.543 Lumbar Lordosis 55 27 41 20 0.059 0.990 Thoracolumbar Kyphosis 42 33 10 9 0.0001 0.930 Pelvic Incidence 48 44 19 49 0.434 0.358 T1 Pelvic Angle 3 18 -2 21 0.364 0.443 Sagittal Balance (mm) 46 13 12 0.589 0.989 Results Table1: Sagittal spinopelvic measurements perioperatively and during follow up. SD: standard deviation. Surgical Group (26 Children) Control Group (196 Children) p values Mean SD Age (years) 13.2 4.3 11.2 4.9 0.02 Thoracic Kyphosis 14 24 18 12 0.422 Lumbar Lordosis 55 27 64 17 0.099 Thoracolumbar Kyphosis 42 33 0.0003 Pelvic Incidence 48 20 49 16 0.969 T1 Pelvic Angle 3 -8 9 0.003 Sagittal Balance (mm) 46 -6 28 0.009 Table2: Comparison between the surgical and control group. SD: standard deviation.

Results Conclusions • 21/26 neurologic complaints resolved postoperatively • Surgical group higher TLK and positive sagittal balance • Thoracic kyphosis, and TLK improved significantly • Un-resolving TLK is associated with increased risk of neurologic deficit • Unresolved TLK by age 10 Increase surveillance Discuss prophylactic surgery Increased propensity for neurologic deficit

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