Delayed stenosis associated with sublaminar band placement in the thoracic spine for proximal junctional kyphosis

Background: Proximal junctional thoracic kyphosis (PJK) is common following adult spinal deformity (ASD) surgery and may require revision operations. In this case series, we present delayed complications associated with the use of sublaminar banding (SLBs) for PJK prophylaxis.

Case description: Three patients underwent long-segment thoracolumbar decompression and fusions for ASD. All had undergone SLB placement for PJK prophylaxis. All three subsequently developed neurologic complications secondary to cephalad spinal cord compression/stenosis requiring urgent revision surgery.

Conclusion: The placement of SLBs placed to prevent PJK may lead to sublaminar inflammation contributing to severe cephalad spinal canal stenosis and myelopathy following ASD surgery. Surgeons should be aware of this potential complication and may consider alternatives to SLB placement to avoid this complication.