Document Detail


Simulated surgery for a patient with neurofibromatosis type-1 who had severe cervicothoracic kyphoscoliosis and an anomalous vertebral artery.
MedLine Citation:
PMID:  20375776     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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:
Masashi Yamazaki; Akihiko Okawa; Takayuki Fujiyoshi; Junko Kawabe; Tomonori Yamauchi; Takeo Furuya; Masashi Takaso; Masao Koda
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Publication Detail:
Type:  Case Reports; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Spine     Volume:  35     ISSN:  1528-1159     ISO Abbreviation:  Spine     Publication Date:  2010 Apr 
Date Detail:
Created Date:  2010-04-21     Completed Date:  2010-07-15     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7610646     Medline TA:  Spine (Phila Pa 1976)     Country:  United States    
Other Details:
Languages:  eng     Pagination:  E368-73     Citation Subset:  IM    
Affiliation:
Spine Section, Department of Orthopaedic Surgery, Chiba University Graduate School of Medicine, Chuo-Ku, Chiba, Japan. masashiy@faculty.chiba-u.jp
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MeSH Terms
Descriptor/Qualifier:
Cervical Vertebrae / radiography,  surgery*
Computer Simulation*
Humans
Kyphosis / complications,  radiography,  surgery*
Laminectomy
Magnetic Resonance Imaging
Male
Middle Aged
Models, Anatomic*
Neurofibromatosis 1 / complications,  radiography,  surgery*
Scoliosis / complications,  radiography,  surgery*
Spinal Fusion
Thoracic Vertebrae / radiography,  surgery*
Treatment Outcome
Vertebral Artery / abnormalities,  radiography,  surgery*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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