Surgical Correction of Dystrophic Spinal Curves in Neurofibromatosis

Parisini, P.; Silvestre, M. Di; Greggi, T.; Paderni, S; Cervellati, S.; Savini, R

doi:10.1097/00007632-199911010-00013

Cited by 77 publications

(65 citation statements)

References 17 publications

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“…38,52,53 It was observed in all 15 patients of our series that underwent preoperative CT or MRI of the lumbosacral region but was not severe. This finding is frequently reported in other disorders besides MFS, 51,54,55 such as neurofibromatosis, 56,57 Ehlers-Danlos syndrome, 58 or ankylosing spondylitis. 59 Dural ectasia causes bony erosion of the lumbosacral vertebrae and thinning of the laminae.…”

Section: Discussionsupporting

confidence: 68%

Surgical Treatment for Scoliosis in Marfan Syndrome

Silvestre

Greggi

Giacomini

et al. 2005

Spine

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These results seemed to demonstrate that a satisfactory stabilization of scoliosis can be achieved by posterior instrumentation alone in patients with Marfan syndrome. Instrumented posterior fusion should be extended to include vertebrae that are neutral and stable in both coronal and sagittal planes before surgery, in order to ensure stabilization of the deformity and reduce the risks of decompensation of the spine.

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Section: Discussionsupporting

confidence: 68%

Surgical Treatment for Scoliosis in Marfan Syndrome

Silvestre

Greggi

Giacomini

et al. 2005

Spine

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“…In a study of Parsini, et al 5) , the failure rate of posterior fusion was higher in the patients with kyphosis greater than 50 degrees, and the addition of planned anterior fusion decreased the failure rate more than 50%.…”

Section: Discussionmentioning

confidence: 92%

Spontaneous Vertebral Column Dislocation in Neurofibromatosis - A Case Report -

Kim

Lee

Suk

et al. 2007

J Korean Orthop Assoc

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“…Winter et al [2] reported on 102 patients with 80 dystrophic curves in 1979. The 1999 paper by an Italian group [8] on 56 patients was, in fact, an updated report of the original 1983 paper.…”

Section: Discussionmentioning

confidence: 99%

“…The instrumentation in neurofibromatous curves is not easy, especially in children, due to small vertebrae, osteoporotic bone, and tumors in and around the cord [2,16]. As a result, we did not plan for major surgical correction; segmental instrumentation with excessive crowding of the bony spinal canal seemed to increase the risk of cord or root injury [8]. Even in the anterior strut grafting, we suggest caution against attempting a major correction with the use of a long or very rigid strut.…”

Section: Discussionmentioning

confidence: 99%

Corpectomy and circumferential spinal fusion in dystrophic neurofibromatous curves

Shahcheraghi

Tavakoli

2010

Journal of Children's Orthopaedics

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Purpose Spinal deformity in neurofibromatosis, when associated with dystrophic change, is a major treatment challenge. Early anterior and posterior spinal fusion is the accepted treatment plan for severe progressive kyphoscoliosis. Resection of the vertebral body as an additional step in correction and fusion has not been previously investigated. Information on the functional status of the neurofibromatous curves is also scarce in the literature. The purpose of this study is to report an experience with corpectomy and circumferential fusion in dystrophic spines of neurofibromatosis. Methods Among 16 patients with dystrophic spinal curves, nine cases who had undergone anterior and posterior fusion with 6.7 years (range 2-11.9) average follow-up were evaluated clinically, radiographically, and functionally . Results Nine cases with a mean age of 11.8 years (range 7.8-17) at surgery consisted of seven kyphoscoliotic patients, who had received one or two levels of cord decompression and corpectomy, and two cases of scoliosis with hypokyphosis. Surgery improved the mean preoperative scoliosis of 87 (range 60-110) and local kyphosis of 69.3°( range 50-100) to 49 (range 15-85) and 49°(range 35-70), respectively. Loss of correction of 5°in the scoliosis and 13°in the kyphosis angles was observed in the final followup. One surgery resulted in an immediate postoperative mortality. Fusion was achieved in all cases. The average SRS-22 score of 4.1 (range 3-4.6) was obtained. Conclusions Simultaneous anterior and posterior fusion with corpectomy for dystrophic neurofibromatous spinal deformities is associated with a high fusion rate, good correction, and also good functional outcome.

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Surgical Correction of Dystrophic Spinal Curves in Neurofibromatosis

Abstract: The severe dystrophic curve with anterior vertebral scalloping always requires combined anterior and posterior stabilization, particularly in younger patients, even if the sagittal curves have not become pathologic by the time of presentation.

Cited by 77 publications

References 17 publications

Surgical Treatment for Scoliosis in Marfan Syndrome

Surgical Treatment for Scoliosis in Marfan Syndrome

Spontaneous Vertebral Column Dislocation in Neurofibromatosis - A Case Report -

Corpectomy and circumferential spinal fusion in dystrophic neurofibromatous curves

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