[Posterior osteotomy and decompression for spinal deformity in patients with achondroplasia].

OBJECTIVE

to evaluate the outcome of surgical treatment for spinal deformity in patients with achondroplasia.

METHODS

six consecutive cases of 3 males and 3 females were recruited. The average age at surgery was 18.5 years old with a range of 12 to 36 years old. All patients suffered thoracolumbar kyphosis and lumbar stenosis. Four patients had neurological deficits due to severe spinal deformity. Posterior osteotomy and decompression were performed in all cases. Long cassette supine radiographs were taken before and after surgery and at the final follow-up. Correction of kyphosis, neurological outcomes (JOA (Japanese Orthopedic Association) scores) and operative complications were recorded and analyzed.

RESULTS

the average follow-up was 10.2 months with a range of 5 to 24 months. The average operative duration was 320 min with a mean 1300 ml of blood loss. The average number of fusion segments was 8 with a range of 5 to 10 segments. Kyphosis was corrected from 53.3° to 13.3° with a 75.0% correction rate. The average preoperative JOA score was 4.5 points and improved to 8.5 points at the final follow-up.

CONCLUSION

posterior osteotomy and decompression is a preferred surgical regiment for thoracolumbar kyphosis and lumbar stenosis in patients with achondroplasia.