Epidemiology and Risk Factors for Kyphotic Deformity After Cervical Intradural Tumor Resection

Overview

This population-based study evaluated 84 adult patients undergoing cervical intradural tumor resection to determine the incidence and predictors of postoperative kyphotic deformity. The analysis identified key risk factors contributing to kyphosis development and assessed the need for delayed posterior fixation surgery.

Background

Spinal intradural tumors, comprising 2–4% of primary CNS tumors, often require surgical resection via a posterior cervical approach involving laminectomy or laminoplasty. This approach disrupts posterior spinal elements and extensor musculature, potentially shifting axial load transmission anteriorly and predisposing patients to cervical kyphosis. Postoperative kyphosis can impair function and may necessitate additional stabilization procedures. However, predictors of kyphotic deformity and subsequent fixation needs remain poorly defined.

Data Highlights

Key Findings

• Postoperative kyphotic increase was measured by the change in C2–C7 Cobb angle between preoperative and long-term follow-up MRI.
• Loss of posterior spinal elements and extensor muscle force after laminectomy predisposes to forward axial load shift and kyphosis.
• Patients undergoing laminectomy without laminoplasty were at higher risk of kyphotic deformity compared to those with laminoplasty.
• Delayed posterior fixation surgery was required in patients presenting with pain or neurological deficits due to kyphosis.
• Multivariable regression identified independent risk factors for kyphotic increase, guiding indications for prophylactic stabilization.

Clinical Implications

Surgeons should consider the risk of postoperative kyphosis when planning cervical intradural tumor resections, especially when performing laminectomy without laminoplasty. Long-term radiological follow-up is essential to detect kyphotic deformity early. Prophylactic stabilization may be warranted in patients with identified risk factors to prevent functional impairment and the need for delayed fixation surgery.

Conclusion

This study highlights the incidence and predictors of kyphotic deformity following cervical intradural tumor resection, emphasizing the importance of surgical technique and follow-up in mitigating postoperative spinal deformity and optimizing patient outcomes.

References

1. Spinal intradural tumors epidemiology and treatment context
2. Surgical techniques and postoperative outcomes in cervical intradural tumor resection