Cervical Kyphosis (Post-laminectomy) Surgery Complication

Post-laminectomy cervical kyphosis, once a common consequence of posterior cervical spine surgery, is now a well-recognized and largely avoided complication. This is largely due to the increased use of anterior cervical decompression and fusion, as well as direct fusion at the time of laminectomy. This complication however is still routinely found in the clinical practice of a deformity spine surgeon. A representative case example is presented. An adult female suffering from difficulty with maintaining erect head position and with axial neck pain many years following cervical laminectomy underwent appropriate imaging evaluation and received a one stage anterior-posterior corrective operation. This patient had developed kyphosis despite absence of the primary risk factors for post-laminectomy deformity: removal of the C2 lamina, removal of four or more laminae, aggressive facetectomy, or age less than 15. An additional significant risk factor of preoperative neutral neck position or kyphosis was unknown. Surgical correction of post-laminectomy kyphosis may include posterior-only fusions, anterior-only fusions with anterior column lengthening, anterior-posterior procedures, or occasionally posterior-anterior-posterior in cases of significant fixed deformity due to ankylosis.