Cargando…
Surgical Treatment of Dystrophic Spinal Curves Caused by Neurofibromatosis Type 1: A Retrospective Study of 26 Patients
Dystrophic scoliosis in neurofibromatosis type 1 (NF-1) is difficult to treat. The purpose of this study was to review the clinical and radiological outcome of surgical treatment of dystrophic spinal curves in NF-1, for analyzing its efficacy, safety, and possible complications. This retrospective s...
Autores principales: | , , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Wolters Kluwer Health
2016
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4998811/ https://www.ncbi.nlm.nih.gov/pubmed/27057895 http://dx.doi.org/10.1097/MD.0000000000003292 |
_version_ | 1782450012382298112 |
---|---|
author | Zhao, Xiong Li, Jun Shi, Lei Yang, Liu Wu, Zi-xiang Zhang, Da-wei Lei, Wei Jie, Qiang |
author_facet | Zhao, Xiong Li, Jun Shi, Lei Yang, Liu Wu, Zi-xiang Zhang, Da-wei Lei, Wei Jie, Qiang |
author_sort | Zhao, Xiong |
collection | PubMed |
description | Dystrophic scoliosis in neurofibromatosis type 1 (NF-1) is difficult to treat. The purpose of this study was to review the clinical and radiological outcome of surgical treatment of dystrophic spinal curves in NF-1, for analyzing its efficacy, safety, and possible complications. This retrospective study consisted of 26 NF-1 patients with spinal deformities treated between 2003 and 2012 in our department. Preoperative X-ray, 3D-CT, and MRI were performed to evaluate the deformities of dystrophic scoliosis accurately. All patients were treated with posterior instrumented fusion alone using screws and hooks. According to the anatomical development situation of each patient's pedicles and the transverse processes, we chose different fixations and different fixed segments. The clinical and radiological outcomes of surgical correction were evaluated postoperatively. The average preoperative kyphosis was 43° (range 15–86°). The postoperative kyphosis had an average of 20° (range 10–39°) yielding 53% correction. At final follow-up, there was an average of 4.6% correction loss. The preoperative scoliosis Cobb angle had an average of 47° (range 35–96°). The postoperative scoliosis Cobb angle had an average of 21° (range 10–37°) yielding 55% correction. At final follow-up, there was an average of 6.6% correction loss. The apical vertebral body rotation was corrected by an average of 48%. At final follow-up, the score of the SRS-30 questionnaire ranged from 97 to 135 with an average of 109. In conclusion, the deformities of dystrophic scoliosis can be accurately determine through preoperative radiolographic evaluation, which plays an important role in guiding the correction of scoliosis program development. The results of this study demonstrate that satisfactory therapeutic effects can be achieved in the dystrophic scoliosis patients by preoperative meticulous surgical plans, intraoperative careful manipulation, and hybrid instrumentation. |
format | Online Article Text |
id | pubmed-4998811 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2016 |
publisher | Wolters Kluwer Health |
record_format | MEDLINE/PubMed |
spelling | pubmed-49988112016-08-29 Surgical Treatment of Dystrophic Spinal Curves Caused by Neurofibromatosis Type 1: A Retrospective Study of 26 Patients Zhao, Xiong Li, Jun Shi, Lei Yang, Liu Wu, Zi-xiang Zhang, Da-wei Lei, Wei Jie, Qiang Medicine (Baltimore) 7100 Dystrophic scoliosis in neurofibromatosis type 1 (NF-1) is difficult to treat. The purpose of this study was to review the clinical and radiological outcome of surgical treatment of dystrophic spinal curves in NF-1, for analyzing its efficacy, safety, and possible complications. This retrospective study consisted of 26 NF-1 patients with spinal deformities treated between 2003 and 2012 in our department. Preoperative X-ray, 3D-CT, and MRI were performed to evaluate the deformities of dystrophic scoliosis accurately. All patients were treated with posterior instrumented fusion alone using screws and hooks. According to the anatomical development situation of each patient's pedicles and the transverse processes, we chose different fixations and different fixed segments. The clinical and radiological outcomes of surgical correction were evaluated postoperatively. The average preoperative kyphosis was 43° (range 15–86°). The postoperative kyphosis had an average of 20° (range 10–39°) yielding 53% correction. At final follow-up, there was an average of 4.6% correction loss. The preoperative scoliosis Cobb angle had an average of 47° (range 35–96°). The postoperative scoliosis Cobb angle had an average of 21° (range 10–37°) yielding 55% correction. At final follow-up, there was an average of 6.6% correction loss. The apical vertebral body rotation was corrected by an average of 48%. At final follow-up, the score of the SRS-30 questionnaire ranged from 97 to 135 with an average of 109. In conclusion, the deformities of dystrophic scoliosis can be accurately determine through preoperative radiolographic evaluation, which plays an important role in guiding the correction of scoliosis program development. The results of this study demonstrate that satisfactory therapeutic effects can be achieved in the dystrophic scoliosis patients by preoperative meticulous surgical plans, intraoperative careful manipulation, and hybrid instrumentation. Wolters Kluwer Health 2016-04-08 /pmc/articles/PMC4998811/ /pubmed/27057895 http://dx.doi.org/10.1097/MD.0000000000003292 Text en Copyright © 2016 Wolters Kluwer Health, Inc. All rights reserved. http://creativecommons.org/licenses/by-nc/4.0 This is an open access article distributed under the Creative Commons Attribution-NonCommercial License, where it is permissible to download, share and reproduce the work in any medium, provided it is properly cited. The work cannot be used commercially. http://creativecommons.org/licenses/by-nc/4.0 |
spellingShingle | 7100 Zhao, Xiong Li, Jun Shi, Lei Yang, Liu Wu, Zi-xiang Zhang, Da-wei Lei, Wei Jie, Qiang Surgical Treatment of Dystrophic Spinal Curves Caused by Neurofibromatosis Type 1: A Retrospective Study of 26 Patients |
title | Surgical Treatment of Dystrophic Spinal Curves Caused by Neurofibromatosis Type 1: A Retrospective Study of 26 Patients |
title_full | Surgical Treatment of Dystrophic Spinal Curves Caused by Neurofibromatosis Type 1: A Retrospective Study of 26 Patients |
title_fullStr | Surgical Treatment of Dystrophic Spinal Curves Caused by Neurofibromatosis Type 1: A Retrospective Study of 26 Patients |
title_full_unstemmed | Surgical Treatment of Dystrophic Spinal Curves Caused by Neurofibromatosis Type 1: A Retrospective Study of 26 Patients |
title_short | Surgical Treatment of Dystrophic Spinal Curves Caused by Neurofibromatosis Type 1: A Retrospective Study of 26 Patients |
title_sort | surgical treatment of dystrophic spinal curves caused by neurofibromatosis type 1: a retrospective study of 26 patients |
topic | 7100 |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4998811/ https://www.ncbi.nlm.nih.gov/pubmed/27057895 http://dx.doi.org/10.1097/MD.0000000000003292 |
work_keys_str_mv | AT zhaoxiong surgicaltreatmentofdystrophicspinalcurvescausedbyneurofibromatosistype1aretrospectivestudyof26patients AT lijun surgicaltreatmentofdystrophicspinalcurvescausedbyneurofibromatosistype1aretrospectivestudyof26patients AT shilei surgicaltreatmentofdystrophicspinalcurvescausedbyneurofibromatosistype1aretrospectivestudyof26patients AT yangliu surgicaltreatmentofdystrophicspinalcurvescausedbyneurofibromatosistype1aretrospectivestudyof26patients AT wuzixiang surgicaltreatmentofdystrophicspinalcurvescausedbyneurofibromatosistype1aretrospectivestudyof26patients AT zhangdawei surgicaltreatmentofdystrophicspinalcurvescausedbyneurofibromatosistype1aretrospectivestudyof26patients AT leiwei surgicaltreatmentofdystrophicspinalcurvescausedbyneurofibromatosistype1aretrospectivestudyof26patients AT jieqiang surgicaltreatmentofdystrophicspinalcurvescausedbyneurofibromatosistype1aretrospectivestudyof26patients |