[Occurrence of a segmental kyphosis after laminectomy of C2 for an aneurysmatic bone cysts--course and treatment strategy].

HISTORY: A 9-year-old girl suffered from an enlarging tumor in the lamina of the axis. After resection of the aneurysmatic bone cyst via laminectomy of C2 an anterior plate-fusion of C2/3 was done. Instead of a correctly placed ventral cervical plate, an adjacent instability of the level C3/4 with kyphosis and subluxation of the facet joints was seen at follow-up. COURSE OF TREATMENT: After reposition over a hypomochlion retention was achieved with a halo body-jacket. Two weeks later the level C3/4 was stabilized by posterior instrumentation. After almost two years the patient has no complaints and the radiological controls show correctly placed instrumentation and increasing bony fusion at the levels C2/3 and C3/4.
CONCLUSION: Especially in children and adolescents laminectomy of a cervical vertebra often leads to kyphotic deformities. When using a posterior approach for surgery of intraspinal lesions or in case of tumors of the dorsal elements of the spine, the laminae and posterior structures should be preserved or, respectively, reconstructed for restoration of traction and tension mechanisms. This is of essential relevance for biomechanical stability and maintenance of the sagittal profile of the spine.