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Postsurgical Deformity, Craniovertebral Junction
Lubdha M. Shah, MD
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KEY FACTS

  • Terminology

    • Top Differential Diagnoses

      • Pathology

        • Clinical Issues

          TERMINOLOGY

          • Synonyms

            • Iatrogenic deformity, iatrogenic instability, postsurgical instability
          • Definitions

            • Postoperative loss of spine motion segment stiffness in which applied force produces greater displacement than normal, with pain/deformity

          IMAGING

          • General Features

            • Radiographic Findings

              • Fluoroscopic Findings

                • CT Findings

                  • MR Findings

                    • Imaging Recommendations

                      DIFFERENTIAL DIAGNOSIS

                        PATHOLOGY

                        • General Features

                          • Staging, Grading, & Classification

                            CLINICAL ISSUES

                            • Presentation

                              • Demographics

                                • Natural History & Prognosis

                                  • Treatment

                                    DIAGNOSTIC CHECKLIST

                                    • Consider

                                      Selected References

                                      1. McAllister BD et al: Is posterior fusion necessary with laminectomy in the cervical spine? Surg Neurol Int. 3(Suppl 3):S225-31, 2012
                                      2. Crostelli M et al: Cervical fixation in the pediatric patient: our experience. Eur Spine J. 18 Suppl 1:20-8, 2009
                                      3. Gottfried ON et al: Spinopelvic parameters in postfusion flatback deformity patients. Spine J. 9(8):639-47, 2009
                                      4. Park DK et al: Problems related to cervical fusion: malalignment and nonunion. Instr Course Lect. 58:737-45, 2009
                                      5. Rahme R et al: Acute swan-neck deformity and spinal cord compression after cervical laminectomy. Can J Neurol Sci. 36(4):504-6, 2009
                                      6. Schwab F et al: Sagittal plane considerations and the pelvis in the adult patient. Spine (Phila Pa 1976). 34(17):1828-33, 2009
                                      7. Heary RF et al: The history of spinal deformity. Neurosurgery. 63(3 Suppl):5-15, 2008
                                      8. Jagannathan J et al: Iatrogenic spinal deformity. Neurosurgery. 63(3 Suppl):104-16, 2008
                                      9. Jang JS et al: Changes in sagittal alignment after restoration of lower lumbar lordosis in patients with degenerative flat back syndrome. J Neurosurg Spine. 7(4):387-92, 2007
                                      10. Kim YJ et al: Results of lumbar pedicle subtraction osteotomies for fixed sagittal imbalance: a minimum 5-year follow-up study. Spine (Phila Pa 1976). 32(20):2189-97, 2007
                                      11. Simmons ED et al: Thirty-six years experience of cervical extension osteotomy in ankylosing spondylitis: techniques and outcomes. Spine (Phila Pa 1976). 31(26):3006-12, 2006
                                      12. Bridwell KH et al: Complications and outcomes of pedicle subtraction osteotomies for fixed sagittal imbalance. Spine (Phila Pa 1976). 28(18):2093-101, 2003
                                      13. Bridwell KH et al: Pedicle subtraction osteotomy for the treatment of fixed sagittal imbalance. J Bone Joint Surg Am. 85-A(3):454-63, 2003
                                      14. Papagelopoulos PJ et al: Spinal column deformity and instability after lumbar or thoracolumbar laminectomy for intraspinal tumors in children and young adults. Spine. 22(4):442-51, 1997
                                      15. Mullin BB et al: The effect of postlaminectomy spinal instability on the outcome of lumbar spinal stenosis patients. J Spinal Disord. 9(2):107-16, 1996
                                      16. An HS et al: Spinal disorders at the cervicothoracic junction. Spine. 19(22):2557-64, 1994
                                      17. Stromqvist B: Postlaminectomy problems with reference to spinal fusion. Acta Orthop Scand Suppl. 251:87-9, 1993
                                      18. Butler JC et al: Postlaminectomy kyphosis. Causes and surgical management. Orthop Clin North Am. 23(3):505-11, 1992
                                      19. Sano S et al: Unstable lumbar spine without hypermobility in postlaminectomy cases. Mechanism of symptoms and effect of spinal fusion with and without spinal instrumentation. Spine. 15(11):1190-7, 1990
                                      20. Mikawa Y et al: Spinal deformity and instability after multilevel cervical laminectomy. Spine (Phila Pa 1976). 12(1):6-11, 1987
                                      Related Anatomy
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                                      Related Differential Diagnoses
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                                      References
                                      Tables

                                      Tables

                                      KEY FACTS

                                      • Terminology

                                        • Top Differential Diagnoses

                                          • Pathology

                                            • Clinical Issues

                                              TERMINOLOGY

                                              • Synonyms

                                                • Iatrogenic deformity, iatrogenic instability, postsurgical instability
                                              • Definitions

                                                • Postoperative loss of spine motion segment stiffness in which applied force produces greater displacement than normal, with pain/deformity

                                              IMAGING

                                              • General Features

                                                • Radiographic Findings

                                                  • Fluoroscopic Findings

                                                    • CT Findings

                                                      • MR Findings

                                                        • Imaging Recommendations

                                                          DIFFERENTIAL DIAGNOSIS

                                                            PATHOLOGY

                                                            • General Features

                                                              • Staging, Grading, & Classification

                                                                CLINICAL ISSUES

                                                                • Presentation

                                                                  • Demographics

                                                                    • Natural History & Prognosis

                                                                      • Treatment

                                                                        DIAGNOSTIC CHECKLIST

                                                                        • Consider

                                                                          Selected References

                                                                          1. McAllister BD et al: Is posterior fusion necessary with laminectomy in the cervical spine? Surg Neurol Int. 3(Suppl 3):S225-31, 2012
                                                                          2. Crostelli M et al: Cervical fixation in the pediatric patient: our experience. Eur Spine J. 18 Suppl 1:20-8, 2009
                                                                          3. Gottfried ON et al: Spinopelvic parameters in postfusion flatback deformity patients. Spine J. 9(8):639-47, 2009
                                                                          4. Park DK et al: Problems related to cervical fusion: malalignment and nonunion. Instr Course Lect. 58:737-45, 2009
                                                                          5. Rahme R et al: Acute swan-neck deformity and spinal cord compression after cervical laminectomy. Can J Neurol Sci. 36(4):504-6, 2009
                                                                          6. Schwab F et al: Sagittal plane considerations and the pelvis in the adult patient. Spine (Phila Pa 1976). 34(17):1828-33, 2009
                                                                          7. Heary RF et al: The history of spinal deformity. Neurosurgery. 63(3 Suppl):5-15, 2008
                                                                          8. Jagannathan J et al: Iatrogenic spinal deformity. Neurosurgery. 63(3 Suppl):104-16, 2008
                                                                          9. Jang JS et al: Changes in sagittal alignment after restoration of lower lumbar lordosis in patients with degenerative flat back syndrome. J Neurosurg Spine. 7(4):387-92, 2007
                                                                          10. Kim YJ et al: Results of lumbar pedicle subtraction osteotomies for fixed sagittal imbalance: a minimum 5-year follow-up study. Spine (Phila Pa 1976). 32(20):2189-97, 2007
                                                                          11. Simmons ED et al: Thirty-six years experience of cervical extension osteotomy in ankylosing spondylitis: techniques and outcomes. Spine (Phila Pa 1976). 31(26):3006-12, 2006
                                                                          12. Bridwell KH et al: Complications and outcomes of pedicle subtraction osteotomies for fixed sagittal imbalance. Spine (Phila Pa 1976). 28(18):2093-101, 2003
                                                                          13. Bridwell KH et al: Pedicle subtraction osteotomy for the treatment of fixed sagittal imbalance. J Bone Joint Surg Am. 85-A(3):454-63, 2003
                                                                          14. Papagelopoulos PJ et al: Spinal column deformity and instability after lumbar or thoracolumbar laminectomy for intraspinal tumors in children and young adults. Spine. 22(4):442-51, 1997
                                                                          15. Mullin BB et al: The effect of postlaminectomy spinal instability on the outcome of lumbar spinal stenosis patients. J Spinal Disord. 9(2):107-16, 1996
                                                                          16. An HS et al: Spinal disorders at the cervicothoracic junction. Spine. 19(22):2557-64, 1994
                                                                          17. Stromqvist B: Postlaminectomy problems with reference to spinal fusion. Acta Orthop Scand Suppl. 251:87-9, 1993
                                                                          18. Butler JC et al: Postlaminectomy kyphosis. Causes and surgical management. Orthop Clin North Am. 23(3):505-11, 1992
                                                                          19. Sano S et al: Unstable lumbar spine without hypermobility in postlaminectomy cases. Mechanism of symptoms and effect of spinal fusion with and without spinal instrumentation. Spine. 15(11):1190-7, 1990
                                                                          20. Mikawa Y et al: Spinal deformity and instability after multilevel cervical laminectomy. Spine (Phila Pa 1976). 12(1):6-11, 1987