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Article: Neurofibromatosis type I with severe dystrophic kyphoscoliosis and its operative management via a simultaneous anterior-posterior approach: A case report and review of the literature

TitleNeurofibromatosis type I with severe dystrophic kyphoscoliosis and its operative management via a simultaneous anterior-posterior approach: A case report and review of the literature
Authors
KeywordsAnterior approach
Deformity
Dystrophic
Kyphoscoliosis
Neurofibromatosis
Posterior approach
Simultaneous procedure
Spinal fusion
Issue Date2005
PublisherElsevier BV. The Journal's web site is located at http://www.elsevier.com/locate/spinee
Citation
Spine Journal, 2005, v. 5 n. 4, p. 461-466 How to Cite?
AbstractBackground context: Neurofibromatosis is an autosomal-dominant hereditary disorder with two subtypes: NF-1 (type I) and NF-2 (type II). NF-1 is a complex disorder with a constellation of manifestations that can also entail skeletal abnormalities, including spinal deformity of a noncongenital nature with early age onset. The short, sharp, angular curve usually present in the thoracic region, as exhibited in NF-1, presents a quandary in its surgical management. Various studies have reported on the efficacy of anterior correction as opposed to posterior alone, whereas others have advocated a sequential, combined approach to diminish the degree of deformity and achieve solid arthrodesis. However, despite solid arthrodesis, curve progression may still ensue. Nonetheless, a simultaneous anterior-posterior approach to treat such a condition of NF-1 with severe dystrophic kyphoscoliosis is a rare occurrence. Purpose: To describe the presentation and operative management of a patient with NF-1 and severe dystrophic kyphoscoliosis. Study design: A case report and review of the literature. Methods: A clinical and radiographic review of a 51-year-old male patient who presented with NF-1, a 165-degree thoracic kyphotic deformity, associated scoliosis, varied degree of vertebral destruction of T9-T11, and paraparesis below T10. Results: Operative intervention of the deformity consisted of a simultaneous anterior-posterior approach and entailed posterior cord exposure, anterior vertebrectomy of T9-T11, cord decompression, posterior osteotomy (posterior elements were auto-fused), anterior distraction and kyphosis correction, anterior strut grafting, anterior rod instrumentation, and posterior compression instrumentation and fusion from T6-L2. The deformity was reduced, sold fusion was noted, and the patient was asymptomatic. Conclusions: A simultaneous anterior-post erior approach for the surgical treatment of severe dystrophic kyphoscoliosis in neurofibromatosis type I is an avenue to properly visualize the spinal cord, achieve solid arthrodesis, and to minimize as well as prevent the progression of deformity. © 2005 Elsevier Inc. All rights reserved.
Persistent Identifierhttp://hdl.handle.net/10722/92896
ISSN
2015 Impact Factor: 2.66
2015 SCImago Journal Rankings: 1.153
References

 

DC FieldValueLanguage
dc.contributor.authorSingh, Ken_HK
dc.contributor.authorSamartzis, Den_HK
dc.contributor.authorAn, HSen_HK
dc.date.accessioned2010-09-22T05:03:04Z-
dc.date.available2010-09-22T05:03:04Z-
dc.date.issued2005en_HK
dc.identifier.citationSpine Journal, 2005, v. 5 n. 4, p. 461-466en_HK
dc.identifier.issn1529-9430en_HK
dc.identifier.urihttp://hdl.handle.net/10722/92896-
dc.description.abstractBackground context: Neurofibromatosis is an autosomal-dominant hereditary disorder with two subtypes: NF-1 (type I) and NF-2 (type II). NF-1 is a complex disorder with a constellation of manifestations that can also entail skeletal abnormalities, including spinal deformity of a noncongenital nature with early age onset. The short, sharp, angular curve usually present in the thoracic region, as exhibited in NF-1, presents a quandary in its surgical management. Various studies have reported on the efficacy of anterior correction as opposed to posterior alone, whereas others have advocated a sequential, combined approach to diminish the degree of deformity and achieve solid arthrodesis. However, despite solid arthrodesis, curve progression may still ensue. Nonetheless, a simultaneous anterior-posterior approach to treat such a condition of NF-1 with severe dystrophic kyphoscoliosis is a rare occurrence. Purpose: To describe the presentation and operative management of a patient with NF-1 and severe dystrophic kyphoscoliosis. Study design: A case report and review of the literature. Methods: A clinical and radiographic review of a 51-year-old male patient who presented with NF-1, a 165-degree thoracic kyphotic deformity, associated scoliosis, varied degree of vertebral destruction of T9-T11, and paraparesis below T10. Results: Operative intervention of the deformity consisted of a simultaneous anterior-posterior approach and entailed posterior cord exposure, anterior vertebrectomy of T9-T11, cord decompression, posterior osteotomy (posterior elements were auto-fused), anterior distraction and kyphosis correction, anterior strut grafting, anterior rod instrumentation, and posterior compression instrumentation and fusion from T6-L2. The deformity was reduced, sold fusion was noted, and the patient was asymptomatic. Conclusions: A simultaneous anterior-post erior approach for the surgical treatment of severe dystrophic kyphoscoliosis in neurofibromatosis type I is an avenue to properly visualize the spinal cord, achieve solid arthrodesis, and to minimize as well as prevent the progression of deformity. © 2005 Elsevier Inc. All rights reserved.en_HK
dc.languageengen_HK
dc.publisherElsevier BV. The Journal's web site is located at http://www.elsevier.com/locate/spineeen_HK
dc.relation.ispartofSpine Journalen_HK
dc.subjectAnterior approachen_HK
dc.subjectDeformityen_HK
dc.subjectDystrophicen_HK
dc.subjectKyphoscoliosisen_HK
dc.subjectNeurofibromatosisen_HK
dc.subjectPosterior approachen_HK
dc.subjectSimultaneous procedureen_HK
dc.subjectSpinal fusionen_HK
dc.titleNeurofibromatosis type I with severe dystrophic kyphoscoliosis and its operative management via a simultaneous anterior-posterior approach: A case report and review of the literatureen_HK
dc.typeArticleen_HK
dc.identifier.emailSamartzis, D:dspine@hku.hken_HK
dc.identifier.authoritySamartzis, D=rp01430en_HK
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.doi10.1016/j.spinee.2004.09.015en_HK
dc.identifier.pmid15996618-
dc.identifier.scopuseid_2-s2.0-21644462353en_HK
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-21644462353&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume5en_HK
dc.identifier.issue4en_HK
dc.identifier.spage461en_HK
dc.identifier.epage466en_HK
dc.publisher.placeNetherlandsen_HK
dc.identifier.scopusauthoridSingh, K=7404762677en_HK
dc.identifier.scopusauthoridSamartzis, D=34572771100en_HK
dc.identifier.scopusauthoridAn, HS=7202277351en_HK

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