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Spinal deformity and instability after multilevel cervical laminectomy.

Y Mikawa, J Shikata, T Yamamuro

    Spine
    |January 1, 1987
    PubMed
    Summary

    Multilevel cervical laminectomy can lead to spinal deformity in some patients, particularly those with ossification of the posterior longitudinal ligament. However, extensive procedures generally do not compromise cervical spine stability in adults.

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    Area of Science:

    • Neurosurgery
    • Orthopedics
    • Spinal Surgery

    Background:

    • Multilevel cervical laminectomy is a surgical procedure to address various spinal conditions.
    • Postoperative spinal deformity and instability are potential complications following laminectomy.
    • Cervical spondylosis (CS) and ossification of the posterior longitudinal ligament (OPLL) are common indications for this surgery.

    Purpose of the Study:

    • To investigate the incidence and characteristics of postoperative spinal deformity and instability after multilevel cervical laminectomy.
    • To compare the development of deformity in patients with cervical spondylosis versus ossification of the posterior longitudinal ligament.
    • To evaluate the long-term effects of extensive laminectomy on cervical spine stability.

    Main Methods:

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  • Retrospective study of 64 patients who underwent multilevel cervical laminectomy.
  • Analysis of postoperative spinal curvature changes and development of deformity (kyphotic or meandering).
  • Special attention to patient subgroups including cervical spondylosis, ossification of the posterior longitudinal ligament, and spinal cord tumors.

    • Main Results:

    • 36% of patients showed postoperative changes in curvature; 14% developed spinal deformity.
    • Deformity occurred early in two juvenile patients requiring spinal fusion.
    • Adult OPLL cases showed a higher tendency for deformity development than CS cases, contrary to prior beliefs.
    • Cervical spine mobility was significantly reduced post-laminectomy in both CS and OPLL groups.
    • No adult required reoperation for severe deformity or instability; extensive laminectomy did not adversely affect overall stability.

    Conclusions:

    • Multilevel cervical laminectomy can result in spinal deformity, with OPLL patients being at higher risk than CS patients.
    • While mobility is reduced, extensive laminectomy, even including C2, appears safe regarding cervical spine stability in adults.
    • Careful monitoring is needed, especially in younger patients, to prevent neurological complications from progressive deformity.