Incidence and predictors of kyphotic deformity following resection of cervical intradural tumors in adults: a population-based cohort study
| Autor: | Per Grane, Gustav Burström, Alexander Fletcher-Sandersjöö, Charles Tatter, Erik Edström, Oscar Persson, Adrian Elmi-Terander |
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| Rok vydání: | 2020 |
| Předmět: |
Adult
Male medicine.medical_specialty medicine.medical_treatment Population Kyphosis Laminoplasty Laminotomy Meningioma 03 medical and health sciences Postoperative Complications 0302 clinical medicine Cervical spine medicine Humans Spinal Cord Neoplasms education Original Article - Spine - Other Aged education.field_of_study Intradural tumor Cobb angle business.industry Incidence Laminectomy Middle Aged medicine.disease Surgery Spinal cord tumor 030220 oncology & carcinogenesis Cervical Vertebrae Female Neurology (clinical) business 030217 neurology & neurosurgery |
| Zdroj: | Acta Neurochirurgica |
| ISSN: | 0942-0940 0001-6268 |
| DOI: | 10.1007/s00701-020-04416-4 |
| Popis: | BackgroundThe first line of treatment for most cervical intradural tumors is surgical resection through laminotomy or laminectomy. This may cause a loss of posterior pulling force leading to kyphosis, which is associated with decreased functional outcome. However, the incidence and predictors of kyphosis in these patients are poorly understood.ObjectTo assess the incidence of posterior fixation (PF), as well as predictors of radiological kyphosis, following resection of cervical intradural tumors in adults.MethodsA population-based cohort study was conducted on adult patients who underwent intradural tumor resection via cervical laminectomy with or without laminoplasty between 2005 and 2017. Primary outcome was kyphosis requiring PF. Secondary outcome was radiological kyphotic increase, measured by the change in the C2–C7 Cobb angle between pre- and postoperative magnetic resonance images.ResultsEighty-four patients were included. Twenty-four percent of the tumors were intramedullary, and the most common diagnosis was meningioma. The mean laminectomy range was 2.4 levels, and laminoplasty was performed in 40% of cases. No prophylactic PF was performed. During a mean follow-up of 4.4 years, two patients (2.4%) required delayed PF. The mean radiological kyphotic increase after surgery was 3.0°, which was significantly associated with laminectomy of C2 and C3. Of these, C3 laminectomy demonstrated independent risk association.ConclusionsThere was a low incidence of delayed PF following cervical intradural tumor resection, supporting the practice of not performing prophylactic PF. Kyphotic increase was associated with C2 and C3 laminectomy, which could help identify at-risk patients were targeted follow-up is indicated. |
| Databáze: | OpenAIRE |
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