28 January 2026
: Case report 
Multilevel Laminectomy for Lumbar Spinal Stenosis With Low Back Pain in Achondroplasia: A Case Report
Challenging differential diagnosis, Congenital defects / diseases
Stylianos Kapetanakis
ABCDEF 1,2, Mikail Chatzivasiliadis CDEF 1*, Christos Koukos BCDEF 1, Paschalis Tsioulas BCDEF 1, Christos Siopis BCDEF 1, Nikolaos Gkantsinikoudis ADEF 1
DOI: 10.12659/AJCR.950290
Am J Case Rep 2026; 27:e950290
Table 1 Summary of pathological spinal features in achondroplasia with their corresponding surgical challenges and recommended practical considerations.
| Anatomical feature | Pathological description | Surgical challenge | Modifications & considerations |
|---|---|---|---|
| Pedicle length [–]8 | Significantly shortened, especially caudally, leading to crowding of spinal elements | Limited space for pedicle screw placement; narrow working corridor | Consider alternative fixation points or shorter screws; meticulous trajectory planning |
| Lamina thickness [,,]8 | Thickened laminae and hypertrophic facets | Requires aggressive bone removal to access dura and neural elements | Use of high-speed burr; careful resection to avoid dural contact |
| Interpedicular distance [,,]8 | Narrows caudally instead of widening, decreasing spinal canal volume | Increases difficulty of bilateral decompression, limits surgical access | Laminectomy is generally favored, though hemilaminectomy may be suitable in selected unilateral cases |
| Dural adherence [,]4 | Dura is thin and often adherent to bone and joint capsule | High intraoperative dural tear risk | Use sharp dissection and avoid forceful elevation of lamina; apply microsurgical techniques |
| Spinal canal size [,]7 | Congenital spinal stenosis (1/3 to 1/2 normal size) due to body morphology | Narrow decompression margin even before degenerative changes appear | Consider earlier surgical intervention; wide, multilevel decompression when needed |
| Spinal alignment [,]8 | Hyperlordosis, thoracolumbar kyphosis, pelvic tilt, and fixed hip flexion deformities | Affects patient positioning and intraoperative orientation | Use prone positioning with hip padding; intraoperative imaging to confirm alignment |