Journal of Spine & NeurosurgeryISSN: 2325-9701

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Case Report, J Spine Neurosurg Vol: 5 Issue: 1

Respiratory Arrest in a Patient with severe Cervical Dystrophic Kyphosis Secondary to Neurofibromatosis Type 1: A Case Report

Kudo D1*, Miyakoshi N1, Abe E2, Kobayashi T2, Hongo M1,Kasukawa Y1, Ishikawa Y1 and Shimada Y1
1Department of Orthopedic Surgery, Akita University, Graduate School of Medicine, Japan
2Department of Orthopedic Surgery, Akita Kosei Medical Center, 1-1-1 Iijima-Nishifukuro, Japan
Corresponding author : Daisuke Kudo
Department of Orthopedic Surgery, Akita University Graduate School of Medicine, 1-1-1 Hondo, Akita 010-8543,Japan,
Tel : +81-18-884-6148; Fax : +81-18-836-2617;
E-mail: [email protected]
Received: November 23, 2015 Accepted: February 09, 2016 Published: February 15, 2016
Citation: Kudo D, Miyakoshi N, Abe E, Kobayashi T, Hongo M (2016) Respiratory Arrest in a Patient with severe Cervical Dystrophic Kyphosis Secondary to Neurofibromatosis Type 1: A Case Report. J Spine Neurosurg 5:1. doi:10.4172/2325-9701.1000208

Abstract

Background: Cases of severe cervical kyphosis due to neurofibromatosis type 1 (NF1) and requiring tracheal intubation are rare. Dystrophic-type NF1 needs a combination of anterior and posterior spinal fusion, and use of sublaminar tape with rods appears reasonable and safe for posterior corrective spinal surgery in patients with this pathology. Case presentation: A 61-year-old woman with severe cervical kyphosis of 139 presented with sudden respiratory arrest before planned spinal surgery. Two-stage posterior and anterior corrective instrumented fusion using multiple segmental sublaminar tape and rods was performed under spinal cord monitoring. Cervical kyphosis was corrected from 104° to 83° and upper thoracic lordosis was corrected from 70° to 37°. Finally, she underwent additional posterior C1-C2 fusion with transarticular screwing for postoperative atlantoaxial subluxation. Solid bone fusion was demonstrated on 2-year follow-up Computed tomography, correction was maintained for 4 years after first surgery, and respiratory function was improved. Conclusion: Rib cage hypoplasia with upper thoracic lordosis secondary to severe cervical kyphosis can lead to acute-on-chronic respiratory failure. Planned corrective posterior spinal fusion with sublaminar tape, followed by anterior spinal fusion with a fibular strut bone resulted in successful solid bone fusion and improvement of respiratory function.

Keywords: Neurofibromatosis; Cervical kyphosis; Sublaminar tape; CO2 narcosis

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