Cord Tethering By Plexiform Neurofibroma: A Rare Cause of Neurological Deficit in Dystrophic Scoliosis

Case: A 12-year-old girl with neurofibromatosis type 1 presented with progressive thoracic scoliosis and neurological deficit. Imaging revealed a dystrophic curve, dorsal syrinx, and tethering of the cord by a plexiform neurofibroma arising from the T7 dorsal ramus. She underwent staged surgery: detethering through T6–T8 laminectomy, followed by posterior spinal deformity correction with Schwab type 2 osteotomies and instrumentation. Conclusion: This rare case highlights the importance of identifying the causes of atypical neurological deficit and the efficacy of a staged surgical approach in achieving neurological recovery and spinal balance in NF-1–associated dystrophic scoliosis with neurological deficit.