Related Articles |
Instrumented fusion for spinal deformity after laminectomy or laminoplasty for resection of intramedullary spinal wire tumors in pediatric sufferers.
Neurosurg Focus. 2017 Oct;43(four):E12
Authors: Hersh DS, Iyer RR, Garzon-Muvdi T, Liu A, Jallo GI, Groves ML
Summary
OBJECTIVE Spinal deformity has turn out to be a well-recognized complication of intramedullary spinal wire tumor (IMSCT) resection. Particularly, laminectomy can lead to biomechanical instability attributable to lack of the posterior stress band. Subsequently, laminoplasty has been proposed as an alternative choice to laminectomy. Right here, the authors describe the most important present collection of pediatric sufferers who’ve undergone laminoplasty for IMSCT resection and examine the necessity for surgical fusion after each laminectomy and laminoplasty. METHODS The medical data of pediatric sufferers who underwent resection of an IMSCT at a single establishment between November 2003 and Might 2014 have been reviewed retrospectively. Demographic, medical, radiological, surgical, histopathological, and follow-up knowledge have been collected. RESULTS Sixty-six consecutive sufferers underwent resection of an IMSCT through the research interval. Forty-three (65%) sufferers have been male. The sufferers had a median age of 12.9 years (interquartile vary [IQR] 7.2-16.5 years) on the time of surgical procedure. Sufferers sometimes offered with a tumor that concerned the cervical and/or thoracic backbone. Nineteen (29%) sufferers underwent laminectomy, and 47 (71%) sufferers underwent laminoplasty. Sufferers in every cohort had an identical charge of postoperative deformity. General, 10 (15%) sufferers required instrumented spinal fusion for spinal deformity. 4 sufferers required revision of the first fusion. CONCLUSIONS These findings present that amongst pediatric sufferers with an IMSCT, postoperative surgical fusion charges stay excessive, even after laminoplasty. Recognized danger elements, such because the age of the affected person, location of the tumor, and the variety of concerned ranges, may play a bigger function than substitute of the laminae in figuring out the speed of surgical fusion after IMSCT resection.
PMID: 28965451 [PubMed – indexed for MEDLINE]