Three-column osteotomy versus Halo-gravity traction combined with posterior column osteotomy in the treatment of dystrophic neurofibromatosis type 1 kyphoscoliosis: a retrospective comparative cohort study.

Background: Dystrophic neurofibromatosis type I (NF1) kyphoscoliosis presents unique challenges for corrective spinal surgery due to anatomical abnormalities. To compare the radiographic and clinical outcomes of dystrophic neurofibromatosis type 1 (NF1) kyphoscoliosis patients undergoing three-colum...

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Publicado en:Journal of Orthopaedic Surgery & Research Vol. 20; no. 1; pp. 1 - 12
Autores principales: Lo, Yuan-Shun, Dai, Yu-Tong, Qiu, Yong, Lin, Erh-Ti Ernest, Hsieh, Hung-Lun, Wei, Xue-Peng, Tsai, Chun-Hao, Fong, Yi-Chin, Chen, Hsien-Te, Tzeng, Shiau-Tzu, Shi, Ben-Long
Formato: research tables/charts Journal Article
Publicado: BioMed Central 5/16/2025
Acceso en línea:Ver este registro en EBSCOhost
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      dt: 5/16/2025
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      pub: BioMed Central
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        10.1186/s13018-025-05842-9
        185240344
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        atl: Three-column osteotomy versus Halo-gravity traction combined with posterior column osteotomy in the treatment of dystrophic neurofibromatosis type 1 kyphoscoliosis: a retrospective comparative cohort study.
      aug:
        au:
          Lo, Yuan-Shun
          Dai, Yu-Tong
          Qiu, Yong
          Lin, Erh-Ti Ernest
          Hsieh, Hung-Lun
          Wei, Xue-Peng
          Tsai, Chun-Hao
          Fong, Yi-Chin
          Chen, Hsien-Te
          Tzeng, Shiau-Tzu
          Shi, Ben-Long
        affil: https://ror.org/00v408z34 Division of Spine Surgery, Department of Orthopedic Surgery, China Medical University Beigang Hospital, China Medical University, Yunlin, Taiwan
      sug:
        subj:
          Spinal Fusion Methods
          Neurofibromatosis 1 Surgery
          Scoliosis Surgery
          Kyphosis Surgery
          Traction Methods
          Gravitation Therapeutic Use
          Osteotomy Methods
          Treatment Outcomes Evaluation
          Human
          Retrospective Design
          Comparative Studies
          Prospective Studies
          Patient Safety
          Neurofibromatosis 1 Radiography
          Scoliosis Radiography
          Kyphosis Radiography
          Blood Loss Estimation
          Descriptive Statistics
          Questionnaires
      ab: Background: Dystrophic neurofibromatosis type I (NF1) kyphoscoliosis presents unique challenges for corrective spinal surgery due to anatomical abnormalities. To compare the radiographic and clinical outcomes of dystrophic neurofibromatosis type 1 (NF1) kyphoscoliosis patients undergoing three-column osteotomy (3CO), halo-gravity traction (HGT), or posterior column osteotomy (PCO) and to evaluate their efficacy and safety in this cohort, different treatment strategies and their associated complication rates warrant further comprehensive investigation. Methods: Dystrophic NF1 kyphoscoliosis were divided into 3CO, HGT, and PCO groups based on the surgical strategy. Radiographic parameters were measured preoperatively, postoperatively, and at each follow-up. Intraoperative and postoperative complications were recorded for each patient, and patient-reported outcomes were assessed using the Scoliosis Research Society-22 (SRS-22) questionnaire. Differences among the three groups were analyzed. Results: A total of 9 patients were included in the 3CO, 22 in HGT group, 95 in PCO groups, respectively. Significant differences among the three groups were found in terms of operation time (p = 0.011), estimated blood loss (p = 0.003), and number of satellite rod techniques (p = 0.013). At pre-operation, the Cobb angles of main curves were 84.3 ± 24.6° in 3CO group, 99.1 ± 24.3° in HGT group, 60.0 ± 16.8° in PCO group. At post-operation, significant post-operative improvements were found in the Cobb angles of the main curves, apical vertebral translation (AVT), segmental kyphosis (SK), and deformity angular ratio (DAR) in all three groups (p < 0.001). No significant correction loss was observed during the follow-up. Six complications were found in the 3CO group, 13 in the HGT group, and 40 in the PCO group. Conclusions: PCO, 3CO, and HGT could be applied to dystrophic NF1 patients. The 3CO is also associated with increased perioperative complications. Level of evidence: IV.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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