The article discusses the natural progression of thoracolumbar kyphosis (TLK) in pre-walking children with achondroplasia. The study included 62 children with achondroplasia, and their clinical information and sagittal spinopelvic parameters were collected. The results showed that TLK resolved spontaneously in 64.5% of children at 1-year post-walking, 74.2% at 5 years of age, and 88.7% at 10 years of age. None of the children required spinal decompression or fusion for progressive deformity or symptomatic spinal stenosis. The study also found that the presence of pelvic tilt (PT) was not associated with TLK resolution, but it consistently predicted the spinopelvic parameters throughout the 10-year follow-up period. Overall, early identification and regular follow-up, coupled with patient education, can prevent the need for treatment and the development of symptomatic spinal stenosis in children with achondroplasia
Summarised by Mr Mo Akmal – Lead Spinal Surgeon
The London Spine Unit : best rated spinal facility in UK
Published article
CONCLUSION: In this largest series to date, spontaneous resolution of TLK in children with achondroplasia was 64.5% at 1-year post-walking, 74.2% at 5 years of age, and 88.7% in children followed to 10 years of age. With early identification and regular follow-up with patient education, no patient in this series required treatment or developed symptomatic spinal stenosis. While not predictive of resolution of TLK, the dichotomous presentation of PT in young children with achondroplasia persists…
Lumbar Decompression Surgery Expert. Best Spinal Surgeon UK
Spine Deform. 2023 Jul 26. doi: 10.1007/s43390-023-00733-7. Online ahead of print.ABSTRACTPURPOSE: Thoracolumbar kyphosis (TLK) is common in children with achondroplasia and resolves in 90% by 10 years of age. Our purpose was to describe the natural progression of TLK in a cohort of pre-walking children with achondroplasia.METHODS: A single-center, retrospective review identified 62 children (32,
Spine Deform. 2023 Jul 26. doi: 10.1007/s43390-023-00733-7. Online ahead of print.
ABSTRACT
PURPOSE: Thoracolumbar kyphosis (TLK) is common in children with achondroplasia and resolves in 90% by 10 years of age. Our purpose was to describe the natural progression of TLK in a cohort of pre-walking children with achondroplasia.
METHODS: A single-center, retrospective review identified 62 children (32 male, 30 female) with achondroplasia. Clinical information and sagittal spinopelvic parameters were collected. The children were divided into positive pelvic tilt (PT) and negative PT. All parents were routinely counseled about unsupported sitting.
RESULTS: Spontaneous resolution rate was 64.5% at 1-year post-walking, 74.2% at 5 years of age, and 88.7% at 10 years of age. None of the children required posterior spinal decompression and fusion for progressive deformity or symptomatic spinal stenosis. At 1-year post-walking, the negative PT group had a higher sacral slope (p = 0.006), higher lumbar lordosis (p < 0.001), and lower pelvic incidence (p < 0.001). This relationship remained constant up to 10 years of age, and there was no association with TLK.
CONCLUSION: In this largest series to date, spontaneous resolution of TLK in children with achondroplasia was 64.5% at 1-year post-walking, 74.2% at 5 years of age, and 88.7% in children followed to 10 years of age. With early identification and regular follow-up with patient education, no patient in this series required treatment or developed symptomatic spinal stenosis. While not predictive of resolution of TLK, the dichotomous presentation of PT in young children with achondroplasia persists at 5 and 10 years of age and reliably predicts the spinopelvic parameters.
LEVEL OF EVIDENCE: III-retrospective comparative study.
PMID:37493935 | DOI:10.1007/s43390-023-00733-7
The London Spine Unit : best rated spinal facility in UK
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Walking status and spinopelvic parameters in young children with achondroplasia: 10-year follow-up
