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Treatment of L5-S1 spondyloptosis with stand-alone anterior lumbar interbody fusion in a patient with neurofibromatosis.
Br J Neurosurg 2019; :1-6BJ

Abstract

BACKGROUND

Neurofibromatosis type 1 (NF1) is a multisystem disorder that causes multiple tumor formations throughout the nervous system. Common spinal dysplasias seen with NF1, such as dural ectasia (DE), often undergo modulation and predispose these patients to spondylolisthesis, making surgical treatment challenging.

CASE DESCRIPTION

A patient with NF1 presented with a 12-year-history of back and left lower extremity radicular pain. Lumbar spine magnetic resonance imaging revealed developmental anomalies with severe DE and associated scalloping of the L4-S1 vertebral bodies and severe L5-S1 Meyerding grade 4 spondylolisthesis. During surgery, post-positioning x-rays demonstrated a grade 5 spondyloptosis. The patient underwent an L5-S1 stand-alone anterior lumbar interbody fusion (ALIF). The final construct was an ALIF cage with one screw into S1, without an anterior plate. By 3-months post-operative, there was complete resolution of preoperative symptoms and at 2 year follow-up the patient was asymptomatic with stable hardware and solid bony fusion. To the authors' knowledge, this is the first report of spondyloptosis treated with a stand-alone ALIF in a patient with NF1 and severe DE.

Authors+Show Affiliations

a Department of Neurological Surgery , Oregon Health & Science University , Portland , OR , USA.a Department of Neurological Surgery , Oregon Health & Science University , Portland , OR , USA.b Division of Vascular Surgery , Department of Surgery , Oregon Health & Science University , Portland , OR , USA.a Department of Neurological Surgery , Oregon Health & Science University , Portland , OR , USA.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

30831035

Citation

Cheaney, Barry, et al. "Treatment of L5-S1 Spondyloptosis With Stand-alone Anterior Lumbar Interbody Fusion in a Patient With Neurofibromatosis." British Journal of Neurosurgery, 2019, pp. 1-6.
Cheaney B, Krause KL, Jung E, et al. Treatment of L5-S1 spondyloptosis with stand-alone anterior lumbar interbody fusion in a patient with neurofibromatosis. Br J Neurosurg. 2019.
Cheaney, B., Krause, K. L., Jung, E., & Than, K. D. (2019). Treatment of L5-S1 spondyloptosis with stand-alone anterior lumbar interbody fusion in a patient with neurofibromatosis. British Journal of Neurosurgery, pp. 1-6. doi:10.1080/02688697.2019.1572868.
Cheaney B, et al. Treatment of L5-S1 Spondyloptosis With Stand-alone Anterior Lumbar Interbody Fusion in a Patient With Neurofibromatosis. Br J Neurosurg. 2019 Mar 4;1-6. PubMed PMID: 30831035.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Treatment of L5-S1 spondyloptosis with stand-alone anterior lumbar interbody fusion in a patient with neurofibromatosis. AU - Cheaney,Barry,2nd AU - Krause,Katie L, AU - Jung,Enjae, AU - Than,Khoi D, Y1 - 2019/03/04/ PY - 2019/3/5/pubmed PY - 2019/3/5/medline PY - 2019/3/5/entrez KW - Neurofibromatosis type 1 KW - anterior lumbar interbody fusion KW - dural ectasia KW - spondylolisthesis SP - 1 EP - 6 JF - British journal of neurosurgery JO - Br J Neurosurg N2 - BACKGROUND: Neurofibromatosis type 1 (NF1) is a multisystem disorder that causes multiple tumor formations throughout the nervous system. Common spinal dysplasias seen with NF1, such as dural ectasia (DE), often undergo modulation and predispose these patients to spondylolisthesis, making surgical treatment challenging. CASE DESCRIPTION: A patient with NF1 presented with a 12-year-history of back and left lower extremity radicular pain. Lumbar spine magnetic resonance imaging revealed developmental anomalies with severe DE and associated scalloping of the L4-S1 vertebral bodies and severe L5-S1 Meyerding grade 4 spondylolisthesis. During surgery, post-positioning x-rays demonstrated a grade 5 spondyloptosis. The patient underwent an L5-S1 stand-alone anterior lumbar interbody fusion (ALIF). The final construct was an ALIF cage with one screw into S1, without an anterior plate. By 3-months post-operative, there was complete resolution of preoperative symptoms and at 2 year follow-up the patient was asymptomatic with stable hardware and solid bony fusion. To the authors' knowledge, this is the first report of spondyloptosis treated with a stand-alone ALIF in a patient with NF1 and severe DE. SN - 1360-046X UR - https://www.unboundmedicine.com/medline/citation/30831035/Treatment_of_L5-S1_spondyloptosis_with_stand-alone_anterior_lumbar_interbody_fusion_in_a_patient_with_neurofibromatosis L2 - http://www.tandfonline.com/doi/full/10.1080/02688697.2019.1572868 DB - PRIME DP - Unbound Medicine ER -