Treatment of Kyphosis and Lumbar Stenosis in Achondroplasia
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.
KeywordsSpinal Canal Spinal Stenosis Posterior Fusion Kyphotic Deformity Posterolateral Fusion
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