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Symptomatic lumbar stenosis following fusion using sublaminar hooks. Case report
J S Myseros1, W C Broaddus, E R Trumble
1Division of Neurological Surgery, Medical College of Virginia, Richmond.
Journal of Neurosurgery
|May 1, 1994
Summary
Sublaminar hooks from spinal fusion surgery can cause lumbar stenosis, leading to pain and weakness. Removing the hooks relieved symptoms and imaging findings in a case study.
Area of Science:
- Neurosurgery
- Spinal Surgery
- Orthopedic Surgery
Background:
- Lumbar fusion with Harrington rod instrumentation is a common procedure for spinal fractures.
- Postoperative complications can include persistent pain and neurological deficits.
Observation:
- A 52-year-old male presented with progressive low-back pain, neurogenic claudication, and lower extremity weakness 11 years after lumbar fusion.
- Radiological examination revealed high-grade lumbar stenosis at the level of caudal sublaminar hooks.
Findings:
- Surgical removal of the sublaminar hooks and decompression of the stenotic area resolved the patient's symptoms.
- Postoperative imaging confirmed the relief of lumbar stenosis.
Implications:
- Sublaminar hooks, though uncommon, can cause postfusion lumbar stenosis and neurological dysfunction.
- Instrumentation near neural elements requires careful consideration as a potential cause of neurological symptoms.