The treatment strategy for rib head protrusion into the spinal canal in type 1 neurofibromatosis scoliosis

English Keywords:Early onset scoliosis  Type 1 neurofibromatosis  Growing rod

English Abstract:

  【Abstract】 Objectives: To investigate the surgical outcome and complications of growing rods in the treatment of early onset scoliosis(EOS) with type 1 neurofibromatosis. Methods: Thirteen cases of EOS with type 1 neurofibromatosis treated with growing rods were studied retrospectively. There were 8 boys and 5 girls, aged from 5 to 10 years old(average, 7.5±2.1 ys). The average follow-up was 5.1±2.8 years(2-10 years). Exptending procedure was carried out every 6 months after first time internal fixation. The Cobb angle, kyphosis angle and trunk height were measured, and the complications were also evaluated. Results: The mean Cobb angle was corrected from 69.0°±21.2°(43°-90°) preoperatively to 25.3°±15.0°(12°-45°) at the final follow-up, the correction rate was 63.3%. The trunk height was corrected from 323.0±29.1mm(288-355mm) to 400.5±25.7mm(361-430mm), and spine grew an average of 11.7±3.3mm per year. There were 16 complications in 9 cases(69.2%), with implant failures in 9 cases(56.3%), junctional kyphosis in 5 cases(31.3%), and wound dehiscence and deep wound infection in 1 case(6.2%). Among 9 cases with kyphosis angle less than 50°, complication was found in 6 cases(66.7%); among 4 cases with kyphosis angle more than 50°, complication was found in 3 cases(75%). There was no significant difference of complication rate between kyphosis more than 50° group and that less than 50°group( χ2=0.123, P=0.726). Conclusions： The use of growing rods in patients with EOS associated with type 1 neurofibromatosis provides curve correction and allows the growth of spine. Kyphosis more than 50° does not increase complications.