Department of Orthopedics, Peking University Third Hospital, Beijing, P. R. China.
Spine (Phila Pa 1976). 2012 Jun 15;37(14):E858-62. doi: 10.1097/BRS.0b013e31824edd1c.
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.
病例报告。
描述一种名为“颈椎悬吊带牵引”的新方法，并报告其在治疗青少年神经纤维瘤病 1 型（NF-1）伴严重颈椎后凸畸形中的疗效。
因 NF-1 导致的颈椎后凸畸形超过 100°是一个具有挑战性的手术问题。单纯手术可能导致矫正效率不佳、融合范围过长、牺牲更多活动节段。
一名 18 岁的 NF-1 青少年患者出现四肢瘫痪。颈椎 X 线片显示 C3-C6 的后凸畸形为 125°。首先进行脊柱松解手术，然后进行颈椎悬吊带牵引和随后的后路器械固定融合手术。
在 4 年的随访中，患者完全恢复了神经功能。C3-C6 的颈椎曲度得到改善，残留后凸 30°。下颈椎获得了稳定的骨性融合，无并发症发生。
颈椎悬吊带牵引是一种可行且安全的辅助技术，可在治疗 NF-1 患者严重僵硬和大曲线畸形时施加逐渐且持续的力量，以最大限度地提高术后矫正效果。本报告有助于扩展针对复杂畸形的分期治疗策略的替代方法。
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