Treatment of scoliosis in children after resection of neuroblastoma—A report of five cases

Abstract

Purpose: Neuroblastoma (NB) is a common extracranial solid tumor in children, often requiring surgical resection. Post-resection NB near the spine can lead to spinal deformities, but treatment strategies are not well-documented. Methods: We retrospectively reviewed our patients who developed spinal deformities after NB resection at our hospital from 2013 to 2021. Treatment included the traditional growing rod (TGR) technique for patients with growth potential, posterior spinal fusion (PSF) for skeletally mature patients, and intermittent cast therapy for infants. Results: Five female patients underwent chemotherapy and surgical resection for NB, with no recurrence during follow-up. Single curves were seen in Cases 1, 2, 4, and 5, and Case 3 had double curves. NB tumors were on the convex side in Cases 1, 3, and 5, and on the concave side in Cases 2 and 4. TGR was used for Cases 1 and 2 due to growth potential and inadequate height. PSF was chosen for Cases 3 and 4, achieving satisfactory scoliosis and kyphosis correction. Case 5, diagnosed with scoliosis at 16 months, underwent intermittent cast therapy for 2 years, significantly correcting scoliosis and avoiding surgery. The average time from NB resection to scoliosis onset was 65.2 ± 49.3 months, with scoliosis treatment starting at 82.6 ± 58.1 months. The mean follow-up was 38.2 ± 12.1 months. All patients showed significant improvement in spinal deformities, with no significant correction loss at the last follow-up. Conclusions: After NB resection, spinal deformities should be closely monitored, with intervention preferably within 6 months of discovery. TGR, PSF, and casting are effective interventions, with the treatment modality based on the patient's skeletal maturity and height.