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14-year-old female with neurofibromatosis (a genetic disorder that disturbs cell growth in the nervous system causing tumors, usually benign, to form on nerve tissue). She presented with a severe thoracic kyphoscoliosis and advanced myelopathy. Her 3-dimensional CT scan and sagittal MRI show her severely angular midthoracic deformity with tenting and thinning of her spinal cord at the apex, the most severe part of the curvature. This caused myelopathy, spinal cord dysfunction, demonstrated by marked walking difficulty (see video 1). She also had spontaneous and sustained clonus, or tremors (see video 2), of her lower extremities.

She underwent preliminary preoperative halo-gravity traction to slowly stretch her spinal cord and decrease some of the pressure on her spinal cord, which allowed her to walk (see video 3). A preoperative model was made of her spine to help plan the surgical reconstruction including the spinal cord decompression. This model can also be studied during surgery to make necessary adjustments to the procedure to provide the best possible outcome.

She underwent a single stage posterior reconstruction from C7 to T12 with a 2-level – T5 and T6 – vertebral column resection. This allowed both decompression of her spinal cord to provide the appropriate room it needed, and correction of her severe kyphoscoliotic spine deformity. Following surgery, she experienced immediate improvement to the strength in her lower extremities and complete neurologic recovery.

Three months following the surgery, she could walk completely normal and was even able to dance (see videos 4 & 5)! Her 2-year postoperative x-rays show maintenance of excellent coronal and sagittal alignment. Before and after clinical photos are sitting preop versus standing postop.