Description

This large series evaluating perioperative complications and potential risk factors in people with achondroplasia found that thoracolumbar surgeries were at the greatest risk for durotomies. In addition, male sex was a risk factor for durotomy, while age was a risk factor for neurologic deficit.

Due to the altered osteogenic development of the spine, people with achondroplasia may develop spinal stenosis. Pervious research shows that up to 50% of adults with achondroplasia have symptomatic spinal stenosis, compared to just 11% in the general population, and up to 78% of those affected have neurologic sequelae. Given the unique anatomy that leads to neurologic deficit and injury, the authors hypothesised that people with achondroplasia are more likely to suffer complications during surgical intervention, and specifically are at risk of dural tears.

This retrospective study aimed to describe common complications and risk factors during spine surgery in 55 patients with achondroplasia undergoing 95 procedures at one clinic in the USA. Overall, 49% of surgeries involved a complication, and almost 14% required return to the operating room.

Importantly, findings showed adults with achondroplasia undergoing surgery chronologically later in the series were at a decreased risk for complications, suggesting surgeon experience may be a key factor. The potential for adverse surgical events should be considered when evaluating patients for spinal surgery.

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