The Role of Scoliosis on the Comorbidity and Demographics of Neurofibromatosis Type-1 Patients: A Retrospective Analysis of the National Inpatient Sample Database

Abstract

Abstract Background Neurofibromatosis type 1 (NF1) is the most common neurocutaneous syndrome in the United States, affecting every 1 in 3000 individuals. NF1 occurs due to non-functional mutations in the NF1 gene, which expresses neurofibromin, a protein involved in tumor suppression. As a result, NF1 typically presents with non-cancerous neoplasm masses called neurofibromas across the body. The most common musculoskeletal abnormality seen in around two-third of NF1 patients is scoliosis, an improver curvature of the spine. However, there is a lack of research on the effects of scoliosis on demographics and morbidities of NF1 patients. Objective We performed a national analysis to investigate the complex relationship between NF1 and scoliosis on patients’ demographics and comorbidities. Method We conducted a retrospective cross-sectional analysis of the 2017 US National Inpatient Sample database using univariable Chi-square analysis and multivariable binary logistic regression analysis to determine the interplay of NF1 and scoliosis on patients’ demographics and comorbidities. Results Our query resulted in 4,635 total NF1 patients, of which 475 (10.25%) had scoliosis and 4,160 (89.75%) did not. Demographic analysis showed that NF1 patients with scoliosis were typically younger, female, and white than when compared to NF1 patients without scoliosis. Comorbidity analysis showed that NF1 patients with scoliosis were more likely to develop malignant brain neoplasms, epilepsy, hydrocephalus, pigmentation disorders, hypothyroidism, diabetes with chronic complications, and coagulopathy disorders. NF1 patients with scoliosis were less likely to develop congestive heart failure, pulmonary circulation disease, peripheral vascular disease, paralysis, chronic pulmonary disease, lymphoma, and psychosis. Conclusion NF1 patients with scoliosis were predominantly younger, female, white patients. The presence of scoliosis in NF1 patients increases the risks for certain brain neoplasms and disorders, but serves a protective effect against some pulmonary and cardiac complications.