Thoracolumbar spinal deformity in achondroplasia

Sanjay N. MisraDivision of Neurosurgery, University of British Columbia, Vancouver, British Columbia, Canada; and Department of Neurosurgery, University of Texas Southwestern Medical Center at Dallas, Texas

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Howard W. MorganDivision of Neurosurgery, University of British Columbia, Vancouver, British Columbia, Canada; and Department of Neurosurgery, University of Texas Southwestern Medical Center at Dallas, Texas

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The authors review the management of thoracolumbar kyphotic deformity in cases of achondroplasia. The presence of angular thoracolumbar kyphosis in achondroplasia is well recognized. In children this is initially a nonfixed deformity that persists, however, in more than 10% of individuals and becomes a fixed thoracolumbar kyphotic deformity. Additionally, with the coexistent spinal canal stenosis, neurological damage can occur and manifest as spinal cord or cauda equina compression. The nature of this condition, the natural history, and management options are discussed. Anatomical and biomechanical factors relevant to the condition are specifically highlighted. Avoidance of pitfalls in the management of these patients is discussed for both pediatric and adult patients.

Abbreviations used in this paper:

AP = anteroposterior; CT = computerized tomography; FGF = fibroblast growth factor; MR = magnetic resonance; TLSO = thoracolumbosacral orthosis.

The authors review the management of thoracolumbar kyphotic deformity in cases of achondroplasia. The presence of angular thoracolumbar kyphosis in achondroplasia is well recognized. In children this is initially a nonfixed deformity that persists, however, in more than 10% of individuals and becomes a fixed thoracolumbar kyphotic deformity. Additionally, with the coexistent spinal canal stenosis, neurological damage can occur and manifest as spinal cord or cauda equina compression. The nature of this condition, the natural history, and management options are discussed. Anatomical and biomechanical factors relevant to the condition are specifically highlighted. Avoidance of pitfalls in the management of these patients is discussed for both pediatric and adult patients.

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