AI Article Synopsis
- - The study investigates body drift in neurofibromatosis scoliosis (NF) compared to adolescent idiopathic scoliosis (AIS), revealing that NF patients experience significant changes in vertebral body positioning due to severe pedicle alterations.
- - Radiographic analyses showed that NF patients had a higher average cobb angle (77.6°) than AIS patients (63.7°), with 9 out of 10 apical vertebrae in the NF group displaying notable body drift, which was absent in the AIS group despite their larger deformity.
- - The findings highlight the necessity for comprehensive preoperative imaging, like 3D CT scans, to mitigate the risk of spinal cord injury during surgery due to body drift in
Article Abstract
Objective: To report on the phenomenon of body drift in neurofibromatosis scoliosis and discuss its implication on surgical safety.
Materials And Methods: Ten dystrophic neurofibromatosis scoliosis (NF) and ten adolescent idiopathic scoliosis (AIS) were studied by radiographs, CT, and MRI. The curve characteristics and a detailed analysis of the morphology of the apical and three adjacent vertebral segments above and below were done. The coronal alignment and the presence of a drift of the vertebral body in relationship to the lamina were carefully studied in both groups and compared.
Results: The mean cobb angle in the NF group was 77.6°, and 63.7° in the AIS group. All the studied vertebra in the NF group had extensive pedicle changes, which were more severe at the apical and periapical regions. Body drift was noted in 29 vertebral segments, with 9/10 of apical segments showing a significant drift. The body drift was associated with significant pedicle dystrophic changes and was independent of the curve magnitude. In comparison, in AIS, no body drift was noted despite a larger deformity and more severe vertebral rotation.
Conclusion: The 'body drift' phenomenon was unique to neurofibromatosis scoliosis and was secondary to severe pedicle morphology changes. This was present even in curves less than 60° and could result in cord injury while instrumenting the concave pedicle. Therefore, a thorough preoperative assessment and planning by a 3D CT are mandatory.
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| http://dx.doi.org/10.1007/s00586-022-07160-8 | DOI Listing |
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