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The role of concurrent fusion to prevent spinal deformity after intramedullary spinal cord tumor excision in children.
J Pediatr Orthop. 2011 Jul-Aug; 31(5):475-9.JP

Abstract

OBJECTIVES

Spinal deformity is a common development after laminectomy and resection of pediatric intramedullary spinal cord tumors. Our objective is to compare the occurrence of postlaminectomy spinal deformity in children with intramedullary spinal cord tumors that underwent decompression with fusion at the time of surgery to those that did not undergo fusion.

METHODS

A retrospective chart review of 255 children with spinal cord tumors treated at 2 tertiary pediatric cancer centers between was performed. Of these, 52 patients with a biopsy-proven intramedullary spinal cord tumor had complete clinical records and radiographic data. Preoperative spinal alignment, surgical treatment, postoperative deformity, and risk factors for deformity were evaluated. All patients had at least 2-year follow-up.

RESULTS

There were 18 females and 34 males with an average age of 8.1 ± 4.1 years. The average time to latest follow-up was 7.6 ± 5.3 years. Moderate or severe postresection spinal deformity (scoliosis > 25 degrees and/or sagittal plane abnormality > 20 degrees requiring bracing or surgery) developed in 57% (21/37) of resections without fusion (laminectomy or laminoplasty alone), and in 27% (4/15) of those with fusion (P = 0.05). Among skeletally mature children, 18 of 28 (64%) developed deformity after laminectomies and laminoplasties, compared with 22% (2/9) of the patients in the fusion group (P = 0.03). Removal of >3 lamina (P = 0.04) was associated with development of postoperative deformity.

CONCLUSIONS

In the surgical treatment of patients with intramedullary spinal cord tumors, those that undergo instrumentation or in situ fusion at the time of spinal cord tumor excision are significantly less likely to develop postresection spinal deformity.

LEVEL OF EVIDENCE

3, Retrospective comparative study.

Links

Publisher Full Text (DOI)

Authors+Show Affiliations

Anakwenze OA
Department of Orthopaedic Surgery, The Hospital of the University of Pennsylvania, Philadelphia, PA, USA. Oanakwenze@gmail.com
Auerbach JD
No affiliation info available
Buck DW
No affiliation info available
Garg S
No affiliation info available
Simon SL
No affiliation info available
Sutton LN
No affiliation info available
Sponseller PD
No affiliation info available
Dormans JP
No affiliation info available

MeSH

BiopsyCervical VertebraeChildFemaleFollow-Up StudiesHumansLaminectomyMaleNeurosurgical ProceduresRetrospective StudiesScoliosisSpinal Cord NeoplasmsSpinal FusionThoracic VertebraeTime FactorsTreatment Outcome

Pub Type(s)

Comparative Study
Journal Article
Multicenter Study

Language

eng

PubMed ID

21654452

Citation

Anakwenze, Oke A., et al. "The Role of Concurrent Fusion to Prevent Spinal Deformity After Intramedullary Spinal Cord Tumor Excision in Children." Journal of Pediatric Orthopedics, vol. 31, no. 5, 2011, pp. 475-9.
Anakwenze OA, Auerbach JD, Buck DW, et al. The role of concurrent fusion to prevent spinal deformity after intramedullary spinal cord tumor excision in children. J Pediatr Orthop. 2011;31(5):475-9.
Anakwenze, O. A., Auerbach, J. D., Buck, D. W., Garg, S., Simon, S. L., Sutton, L. N., Sponseller, P. D., & Dormans, J. P. (2011). The role of concurrent fusion to prevent spinal deformity after intramedullary spinal cord tumor excision in children. Journal of Pediatric Orthopedics, 31(5), 475-9. https://doi.org/10.1097/BPO.0b013e318220bb46
Anakwenze OA, et al. The Role of Concurrent Fusion to Prevent Spinal Deformity After Intramedullary Spinal Cord Tumor Excision in Children. J Pediatr Orthop. 2011 Jul-Aug;31(5):475-9. PubMed PMID: 21654452.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The role of concurrent fusion to prevent spinal deformity after intramedullary spinal cord tumor excision in children. AU - Anakwenze,Oke A, AU - Auerbach,Joshua D, AU - Buck,Donald W, AU - Garg,Sumeet, AU - Simon,Scott L, AU - Sutton,Leslie N, AU - Sponseller,Paul D, AU - Dormans,John P, PY - 2011/6/10/entrez PY - 2011/6/10/pubmed PY - 2011/12/13/medline SP - 475 EP - 9 JF - Journal of pediatric orthopedics JO - J Pediatr Orthop VL - 31 IS - 5 N2 - OBJECTIVES: Spinal deformity is a common development after laminectomy and resection of pediatric intramedullary spinal cord tumors. Our objective is to compare the occurrence of postlaminectomy spinal deformity in children with intramedullary spinal cord tumors that underwent decompression with fusion at the time of surgery to those that did not undergo fusion. METHODS: A retrospective chart review of 255 children with spinal cord tumors treated at 2 tertiary pediatric cancer centers between was performed. Of these, 52 patients with a biopsy-proven intramedullary spinal cord tumor had complete clinical records and radiographic data. Preoperative spinal alignment, surgical treatment, postoperative deformity, and risk factors for deformity were evaluated. All patients had at least 2-year follow-up. RESULTS: There were 18 females and 34 males with an average age of 8.1 ± 4.1 years. The average time to latest follow-up was 7.6 ± 5.3 years. Moderate or severe postresection spinal deformity (scoliosis > 25 degrees and/or sagittal plane abnormality > 20 degrees requiring bracing or surgery) developed in 57% (21/37) of resections without fusion (laminectomy or laminoplasty alone), and in 27% (4/15) of those with fusion (P = 0.05). Among skeletally mature children, 18 of 28 (64%) developed deformity after laminectomies and laminoplasties, compared with 22% (2/9) of the patients in the fusion group (P = 0.03). Removal of >3 lamina (P = 0.04) was associated with development of postoperative deformity. CONCLUSIONS: In the surgical treatment of patients with intramedullary spinal cord tumors, those that undergo instrumentation or in situ fusion at the time of spinal cord tumor excision are significantly less likely to develop postresection spinal deformity. LEVEL OF EVIDENCE: 3, Retrospective comparative study. SN - 1539-2570 UR - https://www.unboundmedicine.com/medline/citation/21654452/The_role_of_concurrent_fusion_to_prevent_spinal_deformity_after_intramedullary_spinal_cord_tumor_excision_in_children_ DB - PRIME DP - Unbound Medicine ER -