Postlaminectomy and postirradiation kyphosis in children and adolescents

This is a retrospective review of 12 patients treated for severe postlaminectomy and postirradiation kyphosis by one surgeon from 1977 to 1994. The average age of the patients was 15 years with a range from 2 to 35 years. The duration of followup ranged from 24 months to 156 months with an average of 65 months. All patients had undergone multilevel laminectomies or irradiation of the thoracic or lumbar spine for an intraspinal lesion or trauma. The average preoperative kyphosis was 84 degrees and this was reduced to an average of 39 degrees after surgery. There were no pseudarthroses and there was an average loss of correction of 5 degrees. There were no complaints of back pain. Moderately severe but flexible kyphoses were treated in three patients by posterior instrumentation and spinal fusion. The other nine patients had combined anterior release or decompression and fusion combined with posterior instrumentation and spinal fusion. Bracing failed to halt the progressive kyphosis in those patients for whom it had been attempted. The only major complications in this series were two wound infections in patients previously treated with irradiation.