Abstract

We have analyzed the arch root morphology, nail placement accuracy, degree of arch deformity, and three-dimensional Cobb angle in patients with NF scoliosis by CT 3D reconstruction. Likewise, we have thoroughly examined arch root morphology, nail placement accuracy, degree of arch deformity, and three-dimensional Cobb angle in patients with idiopathic scoliosis by CT 3D reconstruction. The results of the two groups were statistically analyzed and compared to assess the efficacy and other morphological differences between these groups. For this purpose, 276 patients with scoliosis, including 221 with idiopathic scoliosis and 16 with neurofibromatosis scoliosis, were treated in the hospital, which is from May 2008 to December 2016. The 16 patients with idiopathic scoliosis were matched with patients with neurofibromatosis, and the postoperative CT data were reconstructed in three dimensions, and the measurements included arch morphology, arch transverse diameter, arch-rib joint transverse diameter, three-dimensional coronal Cobb angle, and correction rate. The data of the two groups were statistically analyzed to compare the arch morphology, nail placement accuracy, and treatment effect between patients with NF and patients with AIS. Statistical analysis was performed to compare the differences between NF and AIS patients in terms of morphology, nail placement accuracy, and treatment outcome. The results showed that there were more severely deformed pedicles in NF patients than in idiopathic scoliosis, and the difference between them was statistically significant. Of the 142 screws placed in the NF group, 88 screws were in a good position, and the remaining 54 screws were misplaced.

Highlights

  • Neurofibromatosis is a relatively rare and complex autosomal dominant disease, mostly thought to be associated with mutations in the neurofibromatosis suppressor gene [1], and often manifests cellularly as an abnormal proliferation of neural crest cells, which are important constituent cells during the establishment of the neural tube, and they are able to migrate to various parts of the embryo and differentiate into the appropriate tissues and cells

  • We have thoroughly examined arch root morphology, nail placement accuracy, degree of arch deformity, and three-dimensional Cobb angle in patients with idiopathic scoliosis by CT 3D reconstruction. e results of the two groups were statistically analyzed and compared to assess the efficacy and other morphological differences between these groups

  • Type C atherosclerosis is the second, type E deformity is rare in idiopathic scoliosis, and type D and type E severe pedicle deformities are more common in neurofibromatosis scoliosis than idiopathic scoliosis

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Summary

Introduction

Neurofibromatosis is a relatively rare and complex autosomal dominant disease, mostly thought to be associated with mutations in the neurofibromatosis suppressor gene [1], and often manifests cellularly as an abnormal proliferation of neural crest cells, which are important constituent cells during the establishment of the neural tube, and they are able to migrate to various parts of the embryo and differentiate into the appropriate tissues and cells. Some patients develop skeletal abnormalities (scoliosis deformities, tibial pseudarthrosis), brain tumors (benign meningiomas or even malignant gliomas), peripheral nervous system tumors (intralesional neurofibromas, plexiform fibromas, malignant peripheral nerve sheath tumors), cognitive impairment, and behavioral disturbances that lead to poor social integration and even serious physical health problems [2, 3]. Type II is less common and is mainly characterized by bilateral auditory neuromas with minimal skeletal effects; in this paper, patients with neurofibromatosis I usually have abnormal bone metabolism, abnormal spinal development such as flattened vertebrae, wedge-shaped vertebral body, narrowed pedicles, enlarged intervertebral foramina, and rib protrusion into the spinal canal, resulting in scoliosis. Idiopathic scoliosis is the most common cause of scoliosis; these patients have essentially no abnormal bone development and the pathological curvature is often caused by neuromuscular dysfunction, which accounts for about 80% of the total causes of scoliosis. There are some special types of scoliosis, such as neuromuscular scoliosis, Marfan syndrome, and other interstitial diseases caused by scoliosis, osteochondral dyskinesia combined with scoliosis, and rickets; after spinal trauma, inflammatory tumors of the paravertebral canal can cause scoliosis

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