A 14-year-old girl with neurofibromatosis type 1 (NF1) and dystrophic scoliosis (dural ectasia, posterior vertebral scalloping, and vertebral drift) sustained a lumbar fracture dislocation while cheerleading. She presented with hip pain and a normal neurological examination. She underwent staged posterior spinal fusion with temporary spinopelvic distraction, and then anterior corpectomy and interbody fusion, achieving full recovery at 2 years. In NF1 with dystrophic scoliosis, fracture dislocations may be difficult to appreciate on radiographs. Urgent advanced imaging is essential for timely diagnosis and treatment to reduce morbidity.
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