Robotic-Assisted Correction of Cervicothoracic Deformity in Neurofibromatosis Type 1: A Case Report and Review of Literature

Cervicothoracic deformity correction in patients with dystrophic scoliosis due to neurofibromatosis type 1 (NF1) is technically demanding, owing to the distorted anatomy and poor bone quality. Robotic-assisted spine surgery can enhance accuracy in such complex cases. This report presents the case of a 19-year-old male with NF1 who had progressive cervicothoracic scoliosis and severe back pain. Radiographs revealed severe multi-level curvatures: cervical (53.9°), proximal thoracic (110.8°), and main thoracic (54.7°), with imaging suggestive of a plexiform neurofibroma. The patient underwent robotic-assisted posterior spinal fusion from C3 to T12. The use of the spine robot enabled accurate pedicle screw placement through preoperative planning and intraoperative guidance. Postoperative recovery was smooth, with notable pain relief and functional gains at 3 months. Deformity correction was significant, with postoperative curves reduced to 20° (cervical), 41.1° (proximal thoracic), and 21.7° (main thoracic), and no complications occurred. This case illustrates the value of robotic assistance in complex spinal deformity surgery, particularly in NF1 patients, by improving precision, reducing risks, and enhancing outcomes.