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Treatment of Kyphosis and Lumbar Stenosis in Achondroplasia

  • John E. Lonstein
Part of the Basic Life Sciences book series (BLSC, volume 48)

Abstract

Kyphosis is fairly common in achondroplasia; 30 percent of the early thoracolumbar kyphoses persist. A third of these or approximately 10 percent of achondroplasts have a progressive kyphosis. Some control of the kyphosis early is possible orthotically using an underarm orthosis or TLSO (thoraco-lumbo-sacral-orthosis). This improves the clinical appearance and may have some impact on the lumbosacral hyperlordosis. There are no long term longitudinal studies as yet to document stabilization of the spine in the corrected position. The important question is whether there is a decrease in the 30 percent residual kyphoses or 10 percent progressive kyphoses in adulthood in treated patients. Of additional concern is the respiratory effects of some of these restrictive devices on the pulmonary function in children with small thoraces and thus pre-existing potential respiratory dysfunction.

Keywords

Spinal Canal Spinal Stenosis Posterior Fusion Kyphotic Deformity Posterolateral Fusion 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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References

  1. 1.
    D. Bethem, R.B. Winter, L. Lutter et al., Spinal disorders of dwarfism: review of the literature and report of 80 cases, J. Bone Joint Surg. 63A:1412 (1981).Google Scholar
  2. 2.
    J. Eulert, Scoliosis and kyphosis in dwarfing conditions. Arch. Orthop., Trauma. Surg. 102:45 (1983).CrossRefGoogle Scholar
  3. 3.
    R. M. Hensinger, Kyphosis secondary to skeletal dysplasia and metabolic disease, Clin. Orthop. 128:113 (1977).PubMedGoogle Scholar
  4. 4.
    J. A. Herring and R. B. Winter, Kyphosis in an achondroplastic dwarf, J. Pediatr. Orthop. 3:250 (1983).PubMedCrossRefGoogle Scholar
  5. 5.
    S. E. Kopits, Orthopaedic complications of dwarfism, Clin. Orthop. 114:153 (1976).PubMedGoogle Scholar
  6. 6.
    D. S. Bradford, J. E. Lonstein, J. H. Moe, J. W. Ogilvie and R. B. Winter, “Moe’s Textbook of Scoliosis and Other Spinal Deformities” W. B. Saunders, Philadelphia (1987).Google Scholar
  7. 7.
    K. Bergstrom, U. Laurent and P. O. Lundberg, Neurological symptoms in achondroplasia. Acta Neurol. Scand. 47:59 (1971).PubMedCrossRefGoogle Scholar
  8. 8.
    R. C. Duvisin and M. D. Yahr, Compression spinal cord and root syndromes in achondroplastic dwarfs. Neurology 12:202 (1962).Google Scholar
  9. 9.
    D. W. Hancock and D. G. Phillips, Spinal compression in achon droplasia, Paraplegia 3:23 (1965).PubMedCrossRefGoogle Scholar
  10. 10.
    M. A. Nelson, Spinal stenosis in achondroplasia, Proc. R. Soc. Med. 65:1028 (1972).PubMedGoogle Scholar
  11. 11.
    F. Schrelber and M. Rosenthal, Paraplegia from ruptured disks in achondroplastic dwarfs, J. Neurosurg. 9:648 (1952).CrossRefGoogle Scholar
  12. 12.
    J. D. Spillane, Three cases of achondroplasia with neurological compressions, J. Neurol. Neurosurg. Psychiatr. 15:246 (1952).PubMedCrossRefGoogle Scholar
  13. 13.
    E. Alexander, Significance of the small lumbar spinal canal: cauda equina compression syndromes due to spondylosis. Part 3: Achondroplasia, J. Neurosurg. 31:513 (1969).PubMedCrossRefGoogle Scholar
  14. 14.
    J. A. Bailey, Orthopaedic aspects of achondroplasia, J. Bone Joint Surg., 52A:1285 (1970).Google Scholar
  15. 15.
    L. D. Lutter, J. E. Lonstein, R. B. Winter and L. O. Langer, Anatomy of the achondroplastic lumbar canal, Clin. Orthop. 126:139, (1977).PubMedGoogle Scholar
  16. 16.
    P. Maroleaux and M. Lamy, Achondroplasia in man and animals, Clin. Orthop. 33:91 (1984).Google Scholar
  17. 17.
    L. D. Lutter and L. O. Langer, Neurological symptoms in achondro plastic dwarfs — surgical treatment, J. Bone Joint Surg. 59A:87 (1977).Google Scholar
  18. 18.
    J. E. Lonstein et al., Neurological deficits secondary to spinal deformity, Spine 5:331 (1980).PubMedCrossRefGoogle Scholar

Copyright information

© Plenum Press, New York 1988

Authors and Affiliations

  • John E. Lonstein
    • 1
  1. 1.Dept. of Orthopaedic SurgeryUniversity of MinnesotaMinneapolisUSA

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