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Postlaminectomy cervical dislocation in von Recklinghausen's disease. A case report
G Gioia1, D Mandelli, B Capaccioni
1IV Department of Orthopaedic Surgery, University of Milan Medical School, IRCSS H. San Raffaele, Italy.
Spine
|February 25, 1998
Summary
This case study details the successful surgical management of a pediatric patient with von Recklinghausen
Area of Science:
- Neurosurgery
- Orthopedic Surgery
- Pediatric Neurology
Background:
- Neurofibromatosis, including von Recklinghausen's disease, can present with cervical spine abnormalities.
- Cervical spine involvement in neurofibromatosis poses significant surgical challenges.
- Previous reports highlight the occurrence of neurofibromatosis in the cervical spine.
Observation:
- A 9-year-old girl with von Recklinghausen's disease experienced acute tetraparesis due to C6-C7 dislocation post-laminectomy.
- The patient presented with a complete dislocation of the C6-C7 vertebrae.
- This complication occurred after a prior cervical laminectomy at an outside facility.
Findings:
- The patient underwent a complex, multi-stage surgical procedure involving both anterior and posterior approaches.
- Surgical steps included posterior release, anterior reduction of dislocation, and combined anterior-posterior stabilization.
- Post-operative follow-up exceeding 4.5 years showed a satisfactory neurologic recovery, with the patient regaining ambulation and continence.
Implications:
- Simultaneous anterior and posterior surgical techniques are crucial for managing complex cervical spine abnormalities in neurofibromatosis.
- This case underscores the importance of a comprehensive surgical strategy for spinal deformities associated with neurofibromatosis.
- Effective surgical intervention can lead to significant long-term functional recovery in pediatric patients.