Cervical neurofibromatosis with tetraplegia: management by cervical suspensory traction

Spine (Phila Pa 1976). 2012 Jun 15;37(14):E858-62. doi: 10.1097/BRS.0b013e31824edd1c.

Abstract

Study design: A case report.

Objective: To describe a new method called "cervical suspensory traction" and to report its effect in the treatment of severe cervical kyphotic deformity with neurofibromatosis-1 (NF-1) in a teenager.

Summary of background data: Cervical kyphotic deformity exceeding 100° due to NF-1 is a challenging surgical problem. Surgery alone may result in poor corrective efficiency, too long range of fusion, sacrificing more mobile segments.

Methods: An 18-year-old teenager with NF-1 presented with tetraplegia. Radiographs of the cervical spine revealed that kyphotic deformity of C3-C6 was 125°. Spinal release surgery was undertaken in advance, followed by cervical suspensory traction and subsequent posterior instrumentation and fusion surgery.

Results: During a 4-year follow-up, the patient made a full neurological recovery. Cervical curve of C3-C6 was improved with a residual kyphosis of 30°. Stable bone fusion was obtained in the lower cervical spine. No complication had occurred.

Conclusion: Cervical suspensory traction is a viable and safe adjunct technique for applying gradual and sustained effort to maximize postoperative correction in the treatment of NF-1 patients with severely rigid and large curves. This report should contribute to expanding the alternative method for the staged treatment strategy to complex abnormalities.

Publication types

  • Case Reports

MeSH terms

  • Adolescent
  • Cervical Vertebrae / pathology
  • Cervical Vertebrae / physiopathology
  • Cervical Vertebrae / surgery*
  • Follow-Up Studies
  • Humans
  • Male
  • Neurofibromatosis 1 / complications
  • Neurofibromatosis 1 / physiopathology
  • Neurofibromatosis 1 / surgery*
  • Quadriplegia / complications
  • Quadriplegia / physiopathology
  • Quadriplegia / surgery*
  • Recovery of Function
  • Spinal Fusion
  • Traction / methods*
  • Treatment Outcome