Scolloping of the vertebral bodies in von Recklinghausen's disease of the nervous system (neurofibromatosis).

It is well known that intraspinal tumours may erode the bodies and arches of adjacent vertebrae. Rogers (1955) indicated how vascular intraspinal tumours may erode the backs of the vertebral bodies yet spare the intervertebral discs, in a manner resembling the erosion of vertebrae by an aortic aneurysm. In von Recklinghausen's disease of the nervous system neurofibromatous tumours frequently arise from the sheaths of peripheral, cranial, and spinal nerves. The presence of superficial stigmata of the disease together with hollowing out or scolloping of the posterior surfaces of the vertebral bodies is likely to be interpreted as evidence of intraspinal tumour. In fact, this scolloping may occur in neurofibromatosis as an associated defect in the absence of any intraspinal tumour. Vertebral scolloping has been described in association with lateral thoracic meningocoele by Cross, Reavis, and Saunders (1949) and by Bull (1950). In two-thirds of the reported cases of lateral thoracic meningocoele there has been frank evidence of neurofibromatosis (Nanson, 1957). A case of scolloping without extraspinal meningocoele was demonstrated radiologically by Braun in 1955 and another by Schroder in 1956: in neither instance was exploration or necropsy performed. Whitehouse (1958) noted the deformity in two children; he regarded it as a manifestation of meningocoele, and called it intraspinal meningocoele. We have studied six patients with neurofibromatosis and scolloping of vertebrae who had neither meningocoele nor intraspinal tumour. Two of these cases came to necropsy and two were submitted to laminectomy. Our observations lead us to suggest that the scolloping deformity is of developmental origin. In order that unnecessary exploration of the spinal canal be avoided, we feel that it is important to recognize that scolloping can occur in the absence of both intraspinal tumour and meningocoele. CASE REPORTS