RIB PENETRATION INTO THE SPINAL CANAL IN CASES OF SCOLIOSIS IN PATIENTS WITH NEUROFIBROMATOSIS TYPE-1 (case report and literature review)

Background. Rib penetration into the spinal canal in patients with scoliosis secondary to neurofibromatosis type-1 (NF-1) was described in a relatively small number of publications, though it’s common in clinical practice and not always diagnosed. Materials. The authors report on an adolescent male with NF-1 left thoracic kyphoscoliosis and rib head protrusion into spinal canal with mild initial neurological deficit. Results. A 14-year-old male patient with NF-1 and 68 degrees left thoracic scoliosis and 65 degrees kyphosis was undergoing treatment at the authors’ institution.Preoperative CT scans demonstrated protrusion of the left T11 rib head into the spinal canal on the convexity of the curve, without spinal cord compression. Surgical procedure for resection of the rib head and correction of the spinal deformity was performed which allowed to achieve good deformity correction. The authors also observed almost complete restoration of sensitive functions. Conclusion. Rib head protrusion into the spinal canal can occur in cases of spine deformities with NF-1. If present, the imaging findings should be carefully reviewed for appearance of such lesion that may be obscured by the limitations of CT in the context of a dysplastic spinal deformity.