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Sagittal alignment changes after thoracic laminectomy in adults
Toshimi Aizawa1, Tetsuro Sato, Hiroshi Ozawa
1Department of Orthopaedic Surgery, Tohoku University School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai, 980-8574, Japan. toshi-7@ra2.so-net.ne.jp.
Journal of Neurosurgery. Spine
|June 4, 2008
Summary
Thoracic laminectomy typically results in a minor increase in kyphosis, making spinal fusion unnecessary for most patients. However, long-segment laminectomies in female patients warrant careful radiographic monitoring.
Area of Science:
- Neurosurgery
- Orthopedic Surgery
- Spinal Deformity
Background:
- Thoracic laminectomy is a surgical procedure to address spinal stenosis.
- Post-operative kyphosis is a potential complication following thoracic laminectomy.
- Understanding factors influencing kyphosis is crucial for patient management.
Purpose of the Study:
- To evaluate the degree of kyphosis increase after thoracic laminectomy in adults.
- To identify factors contributing to spinal deformity post-surgery.
- To inform surgical decision-making regarding the necessity of spinal fusion.
Main Methods:
- Retrospective analysis of 58 adult patients undergoing thoracic laminectomy.
- Facet joints preservation and assessment of neurological status using the Japanese Orthopaedic Association (JOA) scale.
- Measurement of local kyphosis using the Cobb angle method, with a minimum 2-year follow-up.
Main Results:
- A modest mean increase of 3.8 degrees in local kyphosis was observed post-surgery.
- No correlation found between neurological improvement (JOA score) and kyphosis progression.
- Female patients undergoing 3-level or more laminectomies showed a significant increase in kyphosis.
Conclusions:
- The overall increase in kyphosis after thoracic laminectomy is generally small.
- Spinal fusion is typically not required following this procedure.
- Close radiographic follow-up is advised for female patients with long-segment laminectomies.
