title: Posterior-only surgical correction of dystrophic scoliosis in 31 patients with neurofibromatosis Type 1 using the multiple anchor point method.
abstract: OBJECTIVE The objective of this study was to evaluate the clinical efficacy of posterior-only surgical correction of dystrophic scoliosis in patients with neurofibromatosis Type 1 (NF1) using a multiple anchor point method (MAPM). METHODS From 2005 to 2014, 31 patients (mean age 13.5 years old, range 10-22 years old) suffering from dystrophic scoliosis associated with NF1 underwent posterior-only surgical correction using a MAPM. The apex of the deformity was thoracic (n = 25), thoracolumbar (n = 4), and lumbar (n = 2). The mean preoperative coronal Cobb angle was 69.1° (range 48.9°-91.4°). The mean Cobb angle on the side-bending radiograph of the convex side was 58.2° (range 40°-79.8°). The mean flexibility and apical vertebral rotation (AVR) were 15.6% (range 8.3%-28.2%) and 2.5° (range 2°-3°), respectively. The mean angle of sagittal kyphosis was 58.3° (range 34.1°-79.6°). RESULTS The mean follow-up period was 53 months (range 12-96 months). The mean postoperative coronal Cobb angle was 27.4° (range 16.3°-46.7°). Postoperatively, the mean AVR and angle of sagittal kyphosis were 1.2° (range 1°-2°) and 22.4° (range 4.2°-36.3°), respectively. All patients showed good correction of all indices postoperatively. The mean postoperative correction rate was 58.7% (range 46.3%-74.1%). At the final follow-up evaluation, the corrective loss rate of the Cobb angle was only 2.3%. Only 1 patient required revision surgery. No severe complications such as spinal cord, neural, or large vascular injury occurred during the operation. CONCLUSIONS Posterior-only surgical correction of dystrophic scoliosis in patients with NF1 using a MAPM could yield satisfactory clinical efficacy of correction and fusion.
authors.affiliation: Department of Spine Surgery, Xiangya Hospital of Central South University, ChangSha, China.
authors.forename: Ang
authors.initials: A
authors.lastname: Deng
authors.affiliation: Department of Spine Surgery, Xiangya Hospital of Central South University, ChangSha, China.
authors.forename: Hong-Qi
authors.initials: HQ
authors.lastname: Zhang
authors.affiliation: Department of Spine Surgery, Xiangya Hospital of Central South University, ChangSha, China.
authors.forename: Ming-Xing
authors.initials: MX
authors.lastname: Tang
authors.affiliation: Department of Spine Surgery, Xiangya Hospital of Central South University, ChangSha, China.
authors.forename: Shao-Hua
authors.initials: SH
authors.lastname: Liu
authors.affiliation: Department of Spine Surgery, Xiangya Hospital of Central South University, ChangSha, China.
authors.forename: Yu-Xiang
authors.initials: YX
authors.lastname: Wang
authors.affiliation: Department of Spine Surgery, Xiangya Hospital of Central South University, ChangSha, China.
authors.forename: Qi-Le
authors.initials: QL
authors.lastname: Gao
mesh_terms: D000293:Adolescent; D002648:Child; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D009456:Neurofibromatosis 1 / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000601:surgery*; D019637:Orthopedic Procedures / Q000379:methods*; D012600:Scoliosis / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000601:surgery*; D055815:Young Adult
keywords: AVR = apical vertebral rotation; MAP = multiple anchor point; MAPM = MAP method; NF1 = neurofibromatosis Type 1; dystrophic scoliosis; multiple anchor point method; neurofibromatosis; posterior-only surgical correction; spine