Five-level cervical corpectomy for neurofibromatosis-associated spinal deformity: case report

Area of Science:

• Neurosurgery
• Spinal Surgery
• Oncology

Background:

• Plexiform neurofibromas can cause severe cervical spine deformities and myelopathy.
• Surgical correction of extensive cervical kyphosis presents significant challenges.

Observation:

• A 43-year-old male with Neurofibromatosis presented with progressive myelopathy and gait disturbance due to a large anterior cervical plexiform neurofibroma.
• Imaging revealed severe kyphotic deformity with spinal cord compression.

Findings:

• A two-stage surgical approach was performed: anterior cervical corpectomy (C2-C6) with reconstruction (C1-C7) followed by posterior occipitocervical-thoracic fusion (O-T8).
• The procedure utilized a custom titanium cage and plate system.
• The patient experienced significant improvement in myelopathy, deformity correction, and quality of life post-surgery.

Implications:

• A five-level cervical corpectomy, including C2, is feasible and safe via a transmandibular, circumglossal approach.
• Circumferential reconstruction with custom implants can effectively address complex cervical deformities.
• This surgical strategy offers a viable option for improving neurological function and quality of life in patients with severe cervical neurofibromas.