Purpose of review The spine is the location of the clinically most important manifestations of achondroplasia. These manifestations include foramen magnum stenosis, thoracolumbar kyphosis, lumbosacral hyperlordosis, and spinal stenosis. Recent findings Decompression for foramen magnum stenosis in infants results in early improvements in respiratory function. However, complications include cerebrospinal fluid leaks, infection and recurrence. There are multiple surgical options for thoracolumbar kyphosis, and the pedicle anatomy has been further elucidated to increase the safety of spinal instrumentation in such patients. Spinal stenosis in pediatric patients with achondroplasia is associated with a significantly larger average percentage decrease in the transverse interpediculate distance from T12 to L5 and a significantly greater thoracolumbar kyphosis angle than in children with achondroplasia but no spinal stenosis. Decompression in pediatric patients carries a high risk of postlaminectomy kyphosis. When decompression is performed in older patients, results are not affected by increased body mass indices. Summary The spinal manifestations of achondroplasia may require surgical treatment. Treatment must consider the anatomic variations unique to the achondroplastic spine.
- Short stature
- Skeletal dysplasias
ASJC Scopus subject areas
- Orthopedics and Sports Medicine