• J Spinal Disord Tech · Jan 2015

    Posterior Correction without Rib Head Resection for Patients with Neurofibromatosis Type 1, Dystrophic Scoliosis, and Rib Head Protrusion into the Spinal Canal.

    • Siyi Cai, Jianguo Zhang, Jianxiong Shen, Hong Zhao, Xisheng Weng, and Guixing Qiu.
    • Department of Orthopaedics, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 1 Shuaifuyuan, Dongcheng District, Beijing, 100730, China.
    • J Spinal Disord Tech. 2015 Jan 24.

    Study DesignA retrospective study.ObjectiveThe objective of this study is to report the result of patients with neurofibromatosis type 1(NF-1), dystrophic scoliosis, and rib head protrusion into the spinal canal who received posterior scoliosis correction surgery without rib head resection.Summary Of Background DataA total of 124 patients with NF-1 and dystrophic scoliosis were treated at our institution during the study period. Eight patients with a median age of 12 years had rib head protrusion into the spinal canal and received surgery and were included in the analysis.MethodsAll eight patients (six male, two female) treated from 2003 to 2013 and received posterior correction with a pedicle screw-rod 3-dimensional correction system or screw-hook hybrid system. Scoliosis correction rate and percentage of spinal canal occupied by the rib head were analyzed.ResultsThe median patient age, number of segments fused, and follow-up duration were 12 years, 10.5, and 22.5 months, respectively. There were no surgery-related complications, and symptoms in all patients were improved after surgery. The median postoperative and 1-year follow-up sagittal kyphotic angles were significantly smaller as compared to the preoperative value (28.5° and 31° vs. 62.5°, P=0.012). The median postoperative coronal Cobb angle of the main thoracic curve was significantly smaller compared to the preoperative value (29° vs. 64.5°, P=0.012). The median percentage of the spinal canal occupied by the intraspinal rib was significantly lower at 1-year follow-up compared with the preoperative value (23.1% vs. 28.6%, P=0.018).ConclusionsPosterior correction without rib head excision can provide good outcomes for patients with NF-1 and dystrophic scoliosis and rib head protrusion into the spinal canal.

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