Sixteen Cases Of Neurofibromatosis With Scoliosis Using 3D Reconstruction To Analyze

[objective ](1)By using CT three-dimensional reconstruction to measure and analyze the NF scoliosis patients with pedicle morphology ?pedicle nail setting accuracy,the degree of deformity,3d Cobb Angle;(2)using CT 3d reconstruction to measure and analyze the AIS patients' s vertebral arch,pedicle nail setting accuracy,the degree of deformation of the vertebral arch root ? 3d Cobb,etc.(3)using statistical methods to analyze the results of the two sets of results,and to evaluate the difference in surgical result and other morphological differences between the two groups;(4)try to summarize the characteristics of patients with neurofibromatosis,and the subject to be noticed in and after surgery.[ method ](1)To collect 276 patients with scoliosis in May 2008 to December 2016 with our hospital diagnosis and treatment,221 cases of idiopathic scoliosis,16 cases of neurofibromatosis scoliosis.Choice 16 patients with idiopathic scoliosis,which exactly matched the NF patients with age ?gender ? curvetype and surgical methods ? Collected the postoperative data include: pedicle morphology,pedicle nail setting accuracy,pedicle transverse diameter,pedicle-rib combination's diameter,3 d coronal Cobb Angle andcorrect rate,etc.;(2)Two sets of data were analyzed statistically,comparing the differences between NF patients and AIS patients with the morphology of the arch,pedicle nail setting accuracy,and the effect of the treatment.[ results ](1)NF patients with severe deformity of pedicle is more than idiopathic scoliosis patients,the difference was statistically significant between the two groups(2)The 142 screws was dropped into NF group,88 of which's position were good,the rest of the 54 pieces dropped in false place,nail setting error rate= 38.02%,nailing setting satisfy rate= 61.98%.111 screws were dropped in patients with idiopathic scoliosis,86 of which's position is good,25 screw's position belonged to level 2 or level 3,screw error rate = 22.52%,nailing correct rate= 77.48%.(3)the diameter of the vertebral arch of the AIS group was measured in 2.73 to 8.33 mm,and its numerical value was changed by segment,the minimum diameter of the concave side was 1.77 mm.The result in the concave vertebra is significantly less than the convex side.The transverse diameter of the thoracic vertebral-rib arch was 10.04-14.91 mm.From T1 to T5,the result vary according to the section.In the cases of NF,the diameter of the thoracic vertebral arch was between 1.37 mm to 8.21 mm,and the thoracic vertebral-rib diameter were less than that of the Ais patients,which were 8.43 to14.55 mm.(4)The clinical results of the NF patients (table 4),preoperative main bend's coronal Cobb Angle of 46 °,126 °(average 68.6 °),postoperative 4°-58 °(average 28.8 °)and postoperative correction rate:34%-92.5%,the average correct rate is 58.8%,the average correct rate is 55.3%.The surgical effects in NF patients were significance,and there exist corrective loss.[ conclusion ] 1,There is a higher deformity in NF patients than those AIS patients;2,Posterior vertebral fusion surgery is Significance to the patients with neurofibromatosis,but have more benefits in AIS patients;3,The vertebral arch of NF patients is smaller,the nail dropping is more difficult,the surgical risk is higher than those of the AIS patients.