Adult Male with Neurofibromatosis and Dural Ectasia

Description

This adult male patient had neurofibromatosis (a nervous system disorder characterized by tumors developing from the nerve tissue). He also had dural ectasia, which means the dura (the protective covering of the spinal cord) is expanding, proliferating, and destroying the surrounding bones. You can see the disappearing lumbar spine on the plain x-rays. On the MRI scans, you can see the massive dural ectasia expanding the spinal canal to 3 times its normal size, and destroying vertebral bodies and posterior elements in its path.

Treatment

Dr. Bridwell treated the patient with pedicle screw instrumentation, multiple iliac screws, and a substantial dose of biologic proteins.

Result

Two years after the surgery, the patient has a solid fusion. You can see the very abundant and robust fusion mass to the sacrum and pelvis on the oblique x-rays, in spite of his extensive dural ectasia.

Note on the Pre-op to Post-op Comparison questionnaire scores that for the pain, function, and mental health questions, the maximum score is 25; for the self-image question, the maximum score is 30; and for the satisfaction question, the maximum score is 10. For the SRS Scores Converted to 100-point Scale, 100 means no pathology. For the Oswestry Scores, 100 means maximum pathology; 1 means no pathology.