Neurofibromatosis Type 1 with Severe Dystrophic Kyphosis: Surgical Treatment and Prognostic Analysis of 27 Patients

Autor: Yu Zhao, Guixing Qiu, Ye Tian, Jianguo Zhang, Jianxiong Shen, Siyi Cai, Hong Zhao
Jazyk: angličtina
Rok vydání: 2020
Předmět:
Zdroj: Orthopaedic Surgery
ISSN: 1757-7861
1757-7853
Popis: Objective The aim of the present study was to explore the surgical treatment and prognosis of 27 cases of neurofibromatosis type 1 with severe dystrophic kyphosis. Methods We performed surgical treatment for scoliosis and kyphosis caused by dystrophic curves at Peking Union Medical College Hospital, Beijing, China from December 2015 to December 2017. The study included 21 patients with moderate to severe kyphosis, 12 males and 9 females, with an average age of 14.95 ± 6.05 years. All patients had kyphosis angles greater than 70° and had more than four skeletal developmental defects. A total of 6 patients with severe kyphosis, 2 males and 4 females, with an average age of 12.5 years, had more than five skeletal developmental defects with a kyphosis angle greater than 90° or a lumbar kyphosis angle greater than 40°. According to the patient's own situation, we adopted a low‐grade surgery scheme (grades 1 or 2) or a high‐grade surgery scheme (grades 3–6). The low‐grade surgery was mainly lower articular surface resection or pontodestomy, and the high‐grade surgery was mainly apical vertebral body or upper discectomy. All patients were followed up to determine their prognosis. Results Statistical analysis showed that there was a significant difference in preoperative and postoperative scores between the two groups (P 0.05). Conclusion Early identification of dysplastic scoliosis‐related deformities plays an important role in surgical planning and prognosis, and low‐level surgical procedures are more favorable for patients' prognosis.
Surgical treatment had a significant effect on scoliosis kyphosis. Approximately 50% of complications after internal fixation were related to high‐level surgery. Gender, age, extent of resection, height, and body mass index had no significant effect on preoperative, postoperative, and prognostic indicators of patients.
Databáze: OpenAIRE
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