Surgical Outcomes in NF-1-Associated Upper Thoracic Dystrophic Scoliosis: A Retrospective Analysis.

Abstract

Upper thoracic NF-1 dystrophic scoliosis typically presents with severe deformity and rapid progression, this study aims to retrospectively analyze the clinical and radiographic outcomes of patients with upper thoracic NF-I dystrophic scoliosis who underwent posterior-only corrective surgery. The research retrospectively analyzed 12 patients diagnosed with upper thoracic NF-I dystrophic scoliosis who underwent surgical treatment between 2017 and 2023. Demographic characteristics and radiographic parameters, follow-up evaluations included pulmonary function tests and patient-reported outcomes assessed using the Scoliosis Research Society-22r (SRS-22r) questionnaire after surgery to comprehensively evaluate clinical efficacy and quality of life. Statistical analysis showed a mean patient age of 14 years and a 28-month follow-up. Posterior correction achieved an average Cobb angle reduction from 63° to 11°, with an 82% correction rate. Pulmonary function improved postoperatively, with slight increases in both FVC and FEV1 at 12 months postoperatively. Compared with baseline, SRS-22r scores demonstrated a progressive improvement over follow-up. Complications included one intraoperative dural tear with cerebrospinal fluid leakage and one case of postoperative intercostal neuralgia. No severe complications-such as neurological deficits or visceral/vascular injuries-were observed. Upper thoracic NF-1 dystrophic scoliosis typically presents with severe deformity and rapid progression. In this anatomically complex region, accurate pedicle screw placement and stable fixation are important, and enabling technologies may support the operative workflow. However, given the retrospective single-center design and heterogeneous implementation, the use of these technologies is exploratory; prospective multicenter studies are warranted.