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KMID : 1146020100030010029
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Journal of Critical Spine Cases
2010 Volume.3 No. 1 p.29 ~ p.32
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Lumbar Spinous Process-Splitting Laminectomy with Interlaminar Fenestration for Multilevel Stenosis in Achondroplasia
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Jang Ho-Suk
Lim Chun-Soo
Hong Yong-Pyo
Seo Jung-Wook
Paik Nam-Chull
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Abstract
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To date, most achondroplastic patients with thoracolumbar stenosis have been treated with multilevel laminectomy with or without instrumented fusion. However extensive damage to the posterior lumbar structures might lead to postoperative instability and failed back surgery syndrome. The authors report a case of achondroplasia with multilevel stenosis which was treated by lumbar spinous process-splitting laminectomy (LSPSL) with interlaminar fenestration, preserving the posterior musculoligamentous complex. A 28-year-old achondroplastic man presented with lower back pain and bilateral leg pain of 4 years duration, 3 months of urinary retention, and erectile dysfunction due to multilevel lumbar stenosis. The LSPSL with interlaminar fenestration and medial facetectomy was performed between L2-3 and L4-5. Radicular pain and neurogenic intermittent claudication of the patient improved immediately after surgery. At 6 months of follow-up, the patient remained neurologically intact, ambulated well, and no progressive kyphosis was noted. Although this is a preliminary study, the LSPSL with interlaminar fenestration can be a useful alternative option for multilevel lumbar stenosis in achondroplasia. To the authors' knowledge, this is the first case of achondroplasia with multilevel stenosis treated by the LSPSL with interlaminar fenestration.
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KEYWORD
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Achondroplasia, Interlaminar fenestration, Lumbar spinous processsplitting laminectomy, Multilevel stenosis
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