Heyde Christoph-E, Völker A, von der Höh N H, Glasmacher S, Koller H
Klinik und Poliklinik für Orthopädie, Unfallchirurgie u. Plastische Chirurgie, Bereich Wirbelsäulenchirurgie, Universitätsklinikum Leipzig AöR, Liebigstraße 20, 04103, Leipzig, Deutschland.
Klinik und Poliklinik für Neurochirurgie, Klinikum rechts der Isar, Technische Universität München, München, Deutschland.
Orthopade. 2021 Aug;50(8):650-656. doi: 10.1007/s00132-021-04130-8. Epub 2021 Jul 8.
With a prevalence of up to 60%, spinal deformity represents the most common skeletal manifestation of neurofibromatosis type 1. The deformity can occur as a non-dystrophic or as a less common dystrophic type. This distinction is of great relevance because the therapeutic strategy is completely different in each case.
NON-DYSTROPHIC TYPE: The non-dystrophic type can be treated like idiopathic scoliosis due to the comparable behavior of both entities. However, care must be taken regarding the so-called modulation. Modulation describes the formation of dysplasias of the spine. This will result in a progression behavior as known from the dystrophic type.
For the dystrophic type, different spinal dysplastic changes are typical. These lead to a rapid progression of deformity and a lack of response to conservative treatment. If untreated, severe and grotesque deformities can arise. This type of deformity requires early surgical intervention, even in childhood. The knowledge about the peculiarities of this disease in general, as well as the typical changes of the spine are prerequisites to managing these often-challenging situations.
脊柱畸形是1型神经纤维瘤病最常见的骨骼表现,患病率高达60%。畸形可表现为非营养不良型或较少见的营养不良型。这种区分非常重要,因为每种情况下的治疗策略完全不同。
由于两者表现相似,非营养不良型可像特发性脊柱侧弯一样治疗。然而,必须注意所谓的调制。调制描述了脊柱发育异常的形成。这将导致出现与营养不良型已知的进展情况。
对于营养不良型,典型的是不同的脊柱发育异常变化。这些会导致畸形迅速进展且对保守治疗无反应。如果不治疗,会出现严重且怪异的畸形。这种类型的畸形即使在儿童期也需要早期手术干预。了解这种疾病的一般特点以及脊柱的典型变化是处理这些常具有挑战性情况的先决条件。