Cervical Spine Deformity Associated With Resection of Spinal Cord Tumors

Daniel R. Fassett, MD, MBA; Randy Clark, MS; Douglas L. Brockmeyer, MD; Meic H. Schmidt, MD

Disclosures

Neurosurg Focus. 2006;20(2):E2 

In This Article

Abstract and Introduction

Abstract

Postoperative sagittal-plane cervical spine deformities are a concern when laminectomy is performed for tumor resection in the spinal cord. These deformities appear to occur more commonly after resection of intramedullary spinal cord lesions, compared with laminectomy for stenosis caused by degenerative spinal conditions. Postlaminectomy deformities are most common in pediatric patients with an immature skeletal system, but are also more common in young adults (<25 years of age) in comparison with older adults. The extent of laminectomy and facetectomy, number of laminae removed, location of laminectomy, preoperative loss of lordosis, and postoperative radiation therapy in the spine have all been reported to influence the risk of postlaminectomy spinal deformities. When these occur, patients should be monitored closely with serial imaging studies, because a significant percentage will have progressive deformities. These can range from focal kyphosis to more complicated swan-neck deformities. General indications for surgical intervention include progressive deformity, axial pain in the area, and neurological symptoms attributable to the deformity. Surgical options include anterior, posterior, and combined anterior-posterior procedures. The authors have reviewed the literature on postlaminectomy kyphosis as it relates to resection of cervical spinal cord tumors, and they summarize some general factors to consider when treating these patients.

Introduction

Cervical deformities, including swan-neck deformities and cervical kyphosis, do not commonly develop after cervical laminectomy. Nonetheless, this condition is more frequently seen within certain patient populations, such as patients who have undergone a laminectomy to treat intramedullary spinal cord lesions. We have reviewed the literature on postlaminectomy cervical spine deformities and will focus on the biomechanical considerations, incidence, risk factors, and management of these deformities as they relate to resection of cervical spinal cord tumors.

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