Surgical outcome after treatment of thoracolumbar spinal stenosis in adults with achondroplasia,European Spine Journal

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Surgical outcome after treatment of thoracolumbar spinal stenosis in adults with achondroplasia
European Spine Journal ( IF 2.6 ) Pub Date : 2024-03-05 , DOI: 10.1007/s00586-024-08181-1
Lukas Urbanschitz ₁ , Dezsö J Jeszenszky ₂ , Mario Ropleato ₂ , Tamás F Fekete ₂

Affiliation

Purpose

To describe the complications and the outcome of patients with achondroplasia undergoing thoracolumbar spinal surgery.

Methods

Retrospective analysis of prospectively collected data of all patients with achondroplasia undergoing surgery within the years 1992–2021 at the thoracic and/or lumbar spine. The outcome was measured by analyzing the surgical complications and revisions. The patient-rated outcome was assessed with the COMI score from 2005 onwards.

Results

A total of 15 patients were included in this study undergoing a total of 31 surgeries at 79 thoracolumbar levels. 12/31 surgeries had intraoperative complications consisting of 11 dural tears and one excessive intraoperative bleeding. 4/18 revision surgeries were conducted due to post-decompression hyperkyphosis. The COMI score decreased from 7.5 IQR 1.4 (range 7.1–9.8) preoperatively to 5.3 IQR 4.1 (2.5–7.5) after 2 years (p = 0.046).

Conclusion

Patients with achondroplasia, the most common skeletal dysplasia condition with short-limb dwarfism, are burdened with a congenitally narrow spinal canal and are commonly in need of spinal surgery. However, surgery in these patients is often associated with complications, namely dural tears and post-decompression kyphosis. Despite these complications, patients benefit from surgical treatment at a follow-up of 2 years after surgery.

中文翻译：

成人软骨发育不全胸腰椎管狭窄症治疗后的手术效果

目的

描述接受胸腰椎手术的软骨发育不全患者的并发症和结果。

方法

对 1992 年至 2021 年期间接受胸椎和/或腰椎手术的所有软骨发育不全患者前瞻性收集的数据进行回顾性分析。通过分析手术并发症和修复来衡量结果。自 2005 年起，患者评价结果采用 COMI 评分进行评估。

结果

本研究共纳入 15 名患者，共接受 79 个胸腰段 31 次手术。 12/31 例手术出现术中并发症，包括 11 例硬脑膜撕裂和 1 例术中出血过多。 4/18因减压后后凸畸形而进行翻修手术。 COMI 评分从术前 7.5 IQR 1.4（范围 7.1-9.8）下降至 2 年后 5.3 IQR 4.1（2.5-7.5）（p = 0.046）。