Cervical neurofibromatosis with tetraplegia: management by cervical suspensory traction.

Abstract

A case report. To describe a new method called "cervical suspensory traction" and to report its effect in the treatment of severe cervical kyphotic deformity with neurofibromatosis-1 (NF-1) in a teenager. Cervical kyphotic deformity exceeding 100° due to NF-1 is a challenging surgical problem. Surgery alone may result in poor corrective efficiency, too long range of fusion, sacrificing more mobile segments. An 18-year-old teenager with NF-1 presented with tetraplegia. Radiographs of the cervical spine revealed that kyphotic deformity of C3-C6 was 125°. Spinal release surgery was undertaken in advance, followed by cervical suspensory traction and subsequent posterior instrumentation and fusion surgery. During a 4-year follow-up, the patient made a full neurological recovery. Cervical curve of C3-C6 was improved with a residual kyphosis of 30°. Stable bone fusion was obtained in the lower cervical spine. No complication had occurred. Cervical suspensory traction is a viable and safe adjunct technique for applying gradual and sustained effort to maximize postoperative correction in the treatment of NF-1 patients with severely rigid and large curves. This report should contribute to expanding the alternative method for the staged treatment strategy to complex abnormalities.