Grade V thoracic spondylolisthesis in neurofibromatosis type-1: a case report and literature review.

BACKGROUND: Grade V thoracic spondylolisthes is secondary to neurofibromatosis type-1(NF-1), especially combined with vertebral fusion, is rare. We reported a case of a 26 year-old female diagnosed with grade V T2spondylolisthesis and T2-T5 autofusion secondary to NF-1, which caused severe kyphotic deformity and neurological deficits, and she was treated with posterior decompression, internal fixation and fusion.

CASE DESCRIPTION: A 26 year-old, right-handed female admitted to the clinic due to weakness of her legs. An eye examination documented a sign of Lisch nodules in the iris. Café-au-lait macules, dermal neurofibroma of multiple forms and rubbery bumps of varying sizes could be observed on her skin. Paresis with muscle strength of 2/5 in both lower extremities with increased muscle tone and decreased muscle mass could be observed. The radiographic results indicated grade V thoracic spondylolisthesis with vertebral fusion from T2-T5 level. To alleviate the neurological dysfunction, posterior decompression, internal fixation and fusion were performed. She reported marked improvement in lower limb motor and sensory functions during the follow-up, and the muscle strength recovered to 5/5.

CONCLUSIONS: Grade V thoracic spondylolisthesis combined with vertebral fusion on T2-T5 level in NF-1 israre. Early surgical intervention of posterior spinal decompression with internal fixation and fusion yielded satisfactory clinical outcomes.