Risk factors associated with rapid progression of scoliosis following intraspinal lesion resection in laminoplasty patients.
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Scoliosis is a rare complication of intraspinal lesions. However, in patients with pre-existing scoliosis who have undergone lesion resection via laminoplasty, the subsequent progression of this deformity and its associated risk factors remain poorly understood. The objective of this study is to investigate the incidence of progressive scoliosis and identify risk factors contributing to its rapid progression in patients who underwent laminoplasty for resection of intraspinal lesions. This study retrospectively analyzed data from patients who underwent laminoplasty for resection of intraspinal lesions between January 2014 to December 2023. Multivariate logistic regression analysis was used to assess the statistical relationship between postoperative scoliosis progression and clinical, radiographic, and surgical-related variables. Fifty-two patients met the inclusion criteria for this study. During a follow-up of 28.5 (IQR,12-59.25) months, 32 patients (61.5%) exhibited scoliosis progression, with a mean progression of (16.3 ± 17.7) °. Notably, 16 patients (30.8%) demonstrated a progression exceeding 10° per annum. In the correlation analysis, variables such as age, Risser index, tumor location, scoliosis degree, the extent of laminoplasty, as well as postoperative syringomyelia, hypertonia and modified McCormick Scale (MMS) were associated with the rapid progression of scoliosis. However, multivariate analysis only identified three independent risk factors: preoperative curvature > 35°, laminoplasty involving ≥ 5 spinal segments, and postoperative hypertonia, which increased the odds of rapid progression by 5.2-, 4.8-, and 6.3-fold, respectively. In conclusion, after laminoplasty for resection of intraspinal lesions, 61.5% of patients with pre-existing scoliosis experienced progression of the deformity, and 30.8% of patients had rapid progression of scoliosis. A Cobb angle exceeding 35°, laminoplasty involving more than 5 vertebral segments, and postoperative hypertonia are all factors that increase the risk of rapid progression of scoliosis after surgery.