Spinal Abnormalities in Neurofibromatosis Type 1 (NF1)

Neurofibromatosis type 1 (NF1) is a common genetic disorder that is associated with spinal
abnormalities which are varied and may include scoliosis, neurofibromas, meningoceles, and
vertebral defects. Skeletal abnormalities occur in more than one third of individuals with
the disorder. These abnormalities are unpredictable and the pathogenesis, natural history,
and clinical outcome remain relatively unclear.

The primary objective of this study is to determine the incidence and clinical history of
NF1-related spinal abnormalities in children with NF1, over a 3-year period.

In the study, researchers will enroll children between ages 6 and 9 years who have been
diagnosed with NF1 to look at changes in the spine. Participants in the study will be
followed yearly for a total of 4 evaluations. Evaluations may include bone scans, spinal
x-rays, magnetic resonance imaging (MRI), computed tomography (CT) scans, and urine samples.

Information gained from this study may lead to a better understanding of the causes of bone
disease in NF1, and improved treatment.

Inclusion Criteria:

- Diagnosis of NF1

- Age greater than 6 years at time of enrollment

- Age less than 9 year and 1 day at time of enrollment

- Tanner Stage not greater than 1

Exclusion Criteria:

- Prior surgical repair of spine

- Short-segment (4-6 vertebrae) curve with a Cobb angle of 45°or more

- Hormone replacement therapy

- Chronic steroid use

- Tibial pseudarthrosis

- Other chronic medical problems known to influence bone health (i.e. diabetes mellitus,
cerebral palsy, etc.)