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We appreciate the comments of Nicita et�al. The index patient we reported did not have a family history of neurofibromatosis (NF) and, thus, was a sporadic case. In consequence, we could not strictly diagnose him with familial spinal NF. However, his presentation was very similar to that of patients with this entity despite the lack of family history. In fact, he also had evident stigmata of NF type 1, as portrayed in Figure�1, A of our report. This highlights the fact expressed by�Nicita et�al that severe spinal NF can present in the context of ?classic? NF type 1 and must be considered in such patients with neurologic deficits and/or�musculoskeletal pain. The patient we reported had normal brain magnetic resonance imaging, but we agree�that it is necessary to evaluate brain str...

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