title: Asymptomatic massive dural ectasia associated with neurofibromatosis type 1 threatening spinal column support: treatment by anterior vascularized fibula graft.
abstract: We report the case of a girl with a dystrophic neurofibromatosis lumbar scoliosis with asymptomatic progression and spread of dystrophic characteristics over 18 years. Resorption of almost the entire anterior column of L1-L4 had occurred despite a previous posterior instrumentation and fusion. A vascularized fibula bone graft wrapped in titanium mesh was used as an anterior structural graft. With close follow-up, the need for this type of salvage surgery might have been averted. Further follow-up showed no graft resorption and unchanged sagittal alignment after 3 years.
authors.affiliation: Department of Orthopaedics, Sint Maartenskliniek, Nijmegen, The Netherlands. m.dekleuver@maartenskliniek.nl
authors.forename: M
authors.initials: M
authors.lastname: de Kleuver
authors.forename: J P W
authors.initials: JP
authors.lastname: van Jonbergen
authors.forename: D D
authors.initials: DD
authors.lastname: Langeloo
mesh_terms: D000293:Adolescent; D004108:Dilatation, Pathologic / Q000209:etiology / Q000601:surgery; D018450:Disease Progression; D004388:Dura Mater / Q000002:abnormalities / Q000473:pathology / Q000601:surgery; D005260:Female; D005360:Fibula / Q000637:transplantation*; D006801:Humans; D008159:Lumbar Vertebrae; D009456:Neurofibromatosis 1 / Q000150:complications*; D012600:Scoliosis / Q000150:complications* / Q000601:surgery; D016896:Treatment Outcome