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. 2022 Jun;31(6):1343-1348.
doi: 10.1007/s00586-022-07160-8. Epub 2022 Apr 1.

The phenomenon of vertebral body drift in neurofibromatosis and its implications for surgical safety

S Rajasekaran  1 , B T Pushpa  2 , Karuppanan Sukumaran Sri Vijay Anand  3 , Ajoy Prasad Shetty  3 , Rishi Mugesh Kanna  3 , Charanjit Singh Dhillon  4
Affiliations

The phenomenon of vertebral body drift in neurofibromatosis and its implications for surgical safety

S Rajasekaran et al. Eur Spine J. 2022 Jun.

Abstract

Objective: To report on the phenomenon of body drift in neurofibromatosis scoliosis and discuss its implication on surgical safety.

Materials and methods: Ten dystrophic neurofibromatosis scoliosis (NF) and ten adolescent idiopathic scoliosis (AIS) were studied by radiographs, CT, and MRI. The curve characteristics and a detailed analysis of the morphology of the apical and three adjacent vertebral segments above and below were done. The coronal alignment and the presence of a drift of the vertebral body in relationship to the lamina were carefully studied in both groups and compared.

Results: The mean cobb angle in the NF group was 77.6°, and 63.7° in the AIS group. All the studied vertebra in the NF group had extensive pedicle changes, which were more severe at the apical and periapical regions. Body drift was noted in 29 vertebral segments, with 9/10 of apical segments showing a significant drift. The body drift was associated with significant pedicle dystrophic changes and was independent of the curve magnitude. In comparison, in AIS, no body drift was noted despite a larger deformity and more severe vertebral rotation.

Conclusion: The 'body drift' phenomenon was unique to neurofibromatosis scoliosis and was secondary to severe pedicle morphology changes. This was present even in curves less than 60° and could result in cord injury while instrumenting the concave pedicle. Therefore, a thorough preoperative assessment and planning by a 3D CT are mandatory.

Keywords: Anatomy changes; Body drift; Dystrophic scoliosis; Neurofibromatosis; Pedicle screw.

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References

    1. Akbarnia BA, Gabriel KR, Beckman E, Chalk D (1992) Prevalence of scoliosis in neurofibromatosis. Spine 17:244–248. https://doi.org/10.1097/00007632-199208001-00005 - DOI
    1. Winter RB, Moe JH, Bradford DS et al (1979) Spine deformity in neurofibromatosis. A review of one hundred and two patients. J Bone Jt Surg Am 61:677–694 - DOI
    1. Calvert PT, Edgar MA, Webb PJ (1989) Scoliosis in neurofibromatosis. The natural history with and without operation. J Bone Jt Surg Br 71:246–251. https://doi.org/10.1302/0301-620X.71B2.2494186 - DOI
    1. Funasaki H, Winter RB, Lonstein JB, Denis F (1994) Pathophysiology of spinal deformities in neurofibromatosis. An analysis of seventy-one patients who had curves associated with dystrophic changes. J Bone Jt Surg Am 76:692–700. https://doi.org/10.2106/00004623-199405000-00010 - DOI
    1. Lykissas MG, Schorry EK, Crawford AH et al (2013) Does the presence of dystrophic features in patients with type 1 neurofibromatosis and spinal deformities increase the risk of surgery? Spine 38:1595–1601. https://doi.org/10.1097/BRS.0b013e31829a7779 - DOI - PubMed

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