Surgical treatment of scoliosis in neurofibromatosis type I: A retrospective study on posterior-only correction with third-generation instrumentation
| Autor: | Giosuè Gargiulo, Silvia Amico, Alessandro Rava, Pasquale Cinnella, Mattia Cravino, Massimo Girardo |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
lcsh:Diseases of the musculoskeletal system Arthrodesis medicine.medical_treatment Scoliosis 03 medical and health sciences 0302 clinical medicine medicine Neurofibromatosis hooks Neurofibromatosis type I 030222 orthopedics pedicle screws Cobb angle business.industry hybrid instrumentations medicine.disease Sagittal plane Surgery medicine.anatomical_structure Coronal plane Orthopedic surgery Original Article Neurology (clinical) sublaminar bands lcsh:RC925-935 business posterior approach 030217 neurology & neurosurgery |
| Zdroj: | Journal of Craniovertebral Junction and Spine, Vol 11, Iss 2, Pp 104-110 (2020) Journal of Craniovertebral Junction & Spine |
| ISSN: | 0974-8237 |
| Popis: | Background: Scoliosis is the most common orthopedic complication of neurofibromatosis type I. Scoliosis can be occurred with two patterns: dystrophic or idiopathic-like. In adolescence, in consideration of bone dystrophy, osteopenia, and often associated hyperkyphosis, most of the authors recommend an anterior-posterior approach. According to other authors, modern instrumentations could be sufficient to sustain a solid posterior arthrodesis. Materials and Methods: Ten patients were diagnosed with scoliosis in neurofibromatosis type I aged between 8 and 25 years, Cobb angle of the thoracic curve >45°, and minimum follow-up (FU) of 1 year and treated with posterior-only approach with third-generation high-density instrumentations. Radiographic measurements were performed on the coronal and sagittal planes. Nonparametric tests (Friedman test and Wilcoxon test) were applied to evaluate the reducibility of the preoperative curve (T0), the postoperative surgical correction (T1), and its maintenance on FU. Results: Statistics showed results compared to those evaluated in the literature with a combined approach regarding surgical correction and its maintenance on FU. On T1, a median correction of 53.5% of the scoliotic curve and of 33.7% of the thoracic hyperkyphosis was observed. On FU, the correction was maintained. A global improvement in balance was appreciated. The curves, despite rigid, showed a relative reducibility to bending tests and traction. No significant complications occurred. Conclusions: The posterior-only approach produces a satisfactory correction of the dystrophic neurofibromatosis scoliosis if associated with the use of high-density third-generation instrumentations. We are confident in recommending posterior-only approach in dystrophic neurofibromatosis scoliosis with coronal curves till 110° and coexisting thoracic kyphosis till 80° |
| Databáze: | OpenAIRE |
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