Long-term outcomes of early-onset scoliosis with neurofibromatosis treated by magnetically controlled growing rod: retrospective case series long-term outcomes

Abstract

Introduction: Neurofibromatosis (NF) is a genetic disorder of the nervous system. It can cause dystrophic or nondystrophic scoliosis. Surgical treatment for scoliosis patients with NF is challenging and the long-term outcomes have rarely been reported. Especially, the long-term outcome of magnetically controlled growing rods (MCGR) treatment on scoliosis patients with NF is missing. Methods: Retrospective data review and radiographic parameters measurement and calculation. Results: There were 4 subjects in this study, whose follow-up period is between 3.5 and 10.6 years. All subjects have a high correction rate of main curve Cobb angle from 12.1% to 67.9% and high correction index from 26.4% to 1092.9%. Their MCGR yearly lengthening is 16.3 ± 3.5 mm (average ± 1 SD). The adverse event (AE) rate is 100% among these patients, including wound infection, pain proximal junctional kyphosis (PJK) and instrument related complication (IRC). And IRC/AE is 53%, all patients suffered from PJK, 3 of them suffered from at least 1 IRC (s). 3.5-year and 8.9-year follow-up subjects have long-term EOSQ-24 records, which show that subjects’ pulmonary function, fatigues and mobility improve in the short-term after surgery; and their general health, physical function improve and parental burden reduction in their follow-up period. Conclusion: Early-onset scoliosis patients with neurofibromatosis are worth treating with MCGR. Although all subjects in this study suffered from PJK and IRC is still high, their perception improved and their spine growth capacity was preserved; MCGR can be lengthened. Subjects’ Cobb angle correction rate and correction index are high