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Simulated surgery for a patient with neurofibromatosis type-1 who had severe cervicothoracic kyphoscoliosis and an anomalous vertebral artery.
Spine (Phila Pa 1976). 2010 Apr 20; 35(9):E368-73.S

Abstract

STUDY DESIGN

Case report.

OBJECTIVE

To describe the usefulness of simulated surgery for evaluation of a patient with neurofibromatosis type-1 (NF-1) who had severe cervicothoracic kyphoscoliosis and an anomalous vertebral artery (VA).

SUMMARY OF BACKGROUND DATA

Several surgical procedures have been used in the treatment of cervicothoracic kyphoscoliosis associated with myelopathy in patients with NF-1. However, to our knowledge, there has been no report that describes a surgical procedure for NF-1 patients with anomalous VA at the cervical spine.

METHODS

A 45-year-old man with NF-1 developed cervical myelopathy. Preoperative examinations revealed severe cervicothoracic kyphoscoliosis, dystrophic changes of the cervical vertebrae, and the anomalous course of a VA and VA aneurysms. To assist in the preoperative planning and intraoperative navigation, we created 3-dimensional (3D) full-scale models of the patient's spine. Using a model, we performed a simulation of the planned surgery for spinal cord decompression with spinal fusion through both anterior and posterior approaches.

RESULTS

Through the simulation, we could evaluate the risk of VA injury at the process of corpectomy, and altered the surgical procedure for the spinal cord decompression with spinal fusion from a posterior approach and a bone graft alone from an anterior approach. We accomplished the surgery successfully without any neurovascular complications. After surgery, the patient experienced relief from myelopathy.

CONCLUSION

Preoperative surgical simulation using a 3D full-scale model was useful for improving the accuracy and safety of the surgery for cervicothoracic kyphoscoliosis with NF-1.

Authors+Show Affiliations

Spine Section, Department of Orthopaedic Surgery, Chiba University Graduate School of Medicine, Chuo-Ku, Chiba, Japan. masashiy@faculty.chiba-u.jpNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Case Reports
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

20375776

Citation

Yamazaki, Masashi, et al. "Simulated Surgery for a Patient With Neurofibromatosis Type-1 Who Had Severe Cervicothoracic Kyphoscoliosis and an Anomalous Vertebral Artery." Spine, vol. 35, no. 9, 2010, pp. E368-73.
Yamazaki M, Okawa A, Fujiyoshi T, et al. Simulated surgery for a patient with neurofibromatosis type-1 who had severe cervicothoracic kyphoscoliosis and an anomalous vertebral artery. Spine. 2010;35(9):E368-73.
Yamazaki, M., Okawa, A., Fujiyoshi, T., Kawabe, J., Yamauchi, T., Furuya, T., Takaso, M., & Koda, M. (2010). Simulated surgery for a patient with neurofibromatosis type-1 who had severe cervicothoracic kyphoscoliosis and an anomalous vertebral artery. Spine, 35(9), E368-73. https://doi.org/10.1097/BRS.0b013e3181c42559
Yamazaki M, et al. Simulated Surgery for a Patient With Neurofibromatosis Type-1 Who Had Severe Cervicothoracic Kyphoscoliosis and an Anomalous Vertebral Artery. Spine. 2010 Apr 20;35(9):E368-73. PubMed PMID: 20375776.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Simulated surgery for a patient with neurofibromatosis type-1 who had severe cervicothoracic kyphoscoliosis and an anomalous vertebral artery. AU - Yamazaki,Masashi, AU - Okawa,Akihiko, AU - Fujiyoshi,Takayuki, AU - Kawabe,Junko, AU - Yamauchi,Tomonori, AU - Furuya,Takeo, AU - Takaso,Masashi, AU - Koda,Masao, PY - 2010/4/9/entrez PY - 2010/4/9/pubmed PY - 2010/7/16/medline SP - E368 EP - 73 JF - Spine JO - Spine VL - 35 IS - 9 N2 - STUDY DESIGN: Case report. OBJECTIVE: To describe the usefulness of simulated surgery for evaluation of a patient with neurofibromatosis type-1 (NF-1) who had severe cervicothoracic kyphoscoliosis and an anomalous vertebral artery (VA). SUMMARY OF BACKGROUND DATA: Several surgical procedures have been used in the treatment of cervicothoracic kyphoscoliosis associated with myelopathy in patients with NF-1. However, to our knowledge, there has been no report that describes a surgical procedure for NF-1 patients with anomalous VA at the cervical spine. METHODS: A 45-year-old man with NF-1 developed cervical myelopathy. Preoperative examinations revealed severe cervicothoracic kyphoscoliosis, dystrophic changes of the cervical vertebrae, and the anomalous course of a VA and VA aneurysms. To assist in the preoperative planning and intraoperative navigation, we created 3-dimensional (3D) full-scale models of the patient's spine. Using a model, we performed a simulation of the planned surgery for spinal cord decompression with spinal fusion through both anterior and posterior approaches. RESULTS: Through the simulation, we could evaluate the risk of VA injury at the process of corpectomy, and altered the surgical procedure for the spinal cord decompression with spinal fusion from a posterior approach and a bone graft alone from an anterior approach. We accomplished the surgery successfully without any neurovascular complications. After surgery, the patient experienced relief from myelopathy. CONCLUSION: Preoperative surgical simulation using a 3D full-scale model was useful for improving the accuracy and safety of the surgery for cervicothoracic kyphoscoliosis with NF-1. SN - 1528-1159 UR - https://www.unboundmedicine.com/medline/citation/20375776/Simulated_surgery_for_a_patient_with_neurofibromatosis_type_1_who_had_severe_cervicothoracic_kyphoscoliosis_and_an_anomalous_vertebral_artery_ L2 - http://dx.doi.org/10.1097/BRS.0b013e3181c42559 DB - PRIME DP - Unbound Medicine ER -