Study design: A case of a 9-year-old girl with von Recklinghausen's disease who has acute tetraparesis caused by a complete dislocation of C6-C7 after a cervical laminectomy performed at another hospital.
Objectives: To demonstrate the treatment difficulties of cervical spine abnormality associated with neurofibromatosis.
Summary of background data: Craig and Govender have reported cases of neurofibromatosis of the cervical spine (1992).
Methods: The patient underwent emergency surgery starting with a posterior release of the articular facets and with the positioning of two Roy-Camille plates. The dislocation of C6-C7 was reduced by an anterior approach. Finally the Roy-Camille plates were removed, a plate was implanted posteriorly at the C6 and C7 joints, and a posterior cable was positioned around the C2-C3 posterior arches.
Results: More than 4.5 years after surgery, the patient's neurologic condition remains satisfactory. She can walk and run and has no sphincter disorders.
Conclusions: The results underline the importance of simultaneous anterior and posterior surgical approaches in this disease.