Spinal deformity following selective dorsal rhizotomy.

Area of Science:

• Neurosurgery
• Orthopedic Surgery
• Pediatric Spine Surgery

Background:

• Selective dorsal rhizotomy (SDR) combined with laminoplasty is a surgical approach used in pediatric patients.
• Spinal deformities are a potential concern following such procedures.

Purpose of the Study:

• To determine the prevalence of spinal deformities after selective dorsal rhizotomy with laminoplasty in ambulatory pediatric patients.
• To assess the long-term radiographic and clinical outcomes related to spinal alignment.

Main Methods:

• Retrospective review of 79 ambulatory pediatric patients who underwent SDR with laminoplasty.
• Radiographic and clinical follow-up, with a mean of 4.2 and 5.8 years, respectively.
• Analysis of scoliosis, kyphosis, lordosis, spondylolisthesis, and back pain.

Main Results:

• Scoliosis (11-24 degrees) was identified in 13% of patients without prior deformity.
• No significant changes in thoracic kyphosis or lumbar lordosis were noted, except for positional differences.
• Spondylolisthesis (12%) was observed, with one case requiring arthrodesis; it correlated with preoperative lumbar lordosis and hip muscle strength.
• Back pain occurred in 5% of patients, with 25% of those having spondylolisthesis.

Conclusions:

• Selective dorsal rhizotomy with laminoplasty is associated with a notable prevalence of scoliosis and spondylolisthesis in pediatric patients.
• While most spinal alignment parameters remained stable, spondylolisthesis warrants attention.
• Periodic radiographic monitoring is advised for early detection of potential spinal deformities post-surgery.