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Clinical outcomes of anterior correction and reconstruction for neurofibromatosis-associated severe cervical kyphotic deformity

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Abstract

Purpose

To assess the clinical outcome of anterior correction and reconstruction for severe cervical kyphotic deformity due to neurofibromatosis type 1 (NF-1).

Methods

In this study, we reviewed a series of seven patients who underwent anterior procedures for correction of NF-1-associated cervical kyphotic deformity. After continuous preoperative skull traction, all patients received anterior corpectomy and fusion (ACCF), anterior discectomy and fusion (ACDF), or combined ACCF and ACDF for surgical correction and reconstruction. Pre- and postoperative local and global Cobb angles, correction rate, sagittal vertical axis (SVA), and T1-slope were assessed by X-ray. Japanese Orthopaedic Association (JOA) score, JOA recovery rate, visual analog scale (VAS), and Neck Disability Index (NDI) scores were recorded to assess the outcome.

Results

Kyphosis was corrected successfully in all patients in terms of local and global Cobb angles (P < 0.05), with a correction rates of 83.1% (range, 66.0 to 115.5%) and 88.6% (range, 61.1 to 125.0%), respectively. JOA scores of patients were improved from preoperative 10.4 (range, 6 to 14) to postoperative 15.4 (range, 14 to 17), with a recovery rate as 77.6% (range, 66.7 to 100%). NDI scores were reduced from preoperative 25.1 (range, 13 to 35) to postoperative 8.7 (range, 5 to 12). VAS scores were reduced from preoperative 7.0 (range, 4 to 9) to postoperative 2.3 (range, 1 to 3).

Conclusion

This study has demonstrated that anterior correction and reconstruction is an alternative option for the treatment of NF-1-associated severe cervical kyphosis when deformity is localized, flexible, or fixed.

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Funding

This study is supported by a grant from National Natural Science Foundation of China (81501918).

No relevant financial activities outside the submitted work.

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Author notes

  1. Dr. Shen Xiaolong contributed equally to the article as co-first author.

Authors and Affiliations

  1. Department of Spine Surgery, Changzheng Hospital, Second Military Medical University, 415 Fengyang Road, Shanghai, China

    Gu Yifei, Shen Xiaolong, Liu Yang, Cao Peng & Yuan Wen

Authors
  1. Gu Yifei
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  2. Shen Xiaolong
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  3. Liu Yang
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  4. Cao Peng
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  5. Yuan Wen
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Corresponding authors

Correspondence to Cao Peng or Yuan Wen.

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The manuscript submitted does not contain information about medical device(s)/drug(s).

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

Our research was approved by the ethics department of Changzheng Hospital, Shanghai. We have consensus with all participants. We also followed the Declaration of Helsinki and relevant policies in China.

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Yifei, G., Xiaolong, S., Yang, L. et al. Clinical outcomes of anterior correction and reconstruction for neurofibromatosis-associated severe cervical kyphotic deformity. International Orthopaedics (SICOT) 43, 639–646 (2019). https://doi.org/10.1007/s00264-018-4050-4

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  • DOI: https://doi.org/10.1007/s00264-018-4050-4

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