Vertebral scalloping in neurofibromatosis-1

A 39-year-old male patient known to have neurofibromatosis-1, presented with sciatica and low back pain. At the age of 27, an MRI of the spine revealed widening of the lumbar canal due to posterior scalloping of the last 4 lumbar vertebrae. Repeat MRI and simple lateral lumbosacral plain film at the age of 39, revealed significant progression of the lumbosacral lesion. In view of the progression of the disease during the last 15 years, we opted for insertion of a lumbo-peritoneal [LP] shunt to decrease the CSF pressure, which is the most probable cause of scalloping. We shied away from lumbar fixation as we thought that this would not stop the vertebral erosion. The LP shunt affected good symptomatic and radiologic outcome over a 2-year follow up

Long fusion for de novo adult degenerative lumbar scoliosis

We present a retrospective review of 11 patients who underwent single stage posterior correction and instrumented fusion for adult degenerative lumbar scoliosis. At an average follow-up of 28 months, up to 50% correction of the deformity was obtained with satisfactory clinical results. The results suggest that need for revision and poor clinical outcome is related to inadequate restoration of lumbar lordosis and the sagittal profile