Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.
ADVANCED SEARCH
Log in
Top
European Spine Journal
Published in: European Spine Journal 7/2014

01-07-2014 | Original Article

Long-term surgical outcomes of cervical myelopathy with athetoid cerebral palsy

Authors: Keung Nyun Kim, Poong Gee Ahn, Mi Jung Ryu, Dong Ah Shin, Seong Yi, Do Heum Yoon, Yoon Ha

Published in: European Spine Journal | Issue 7/2014

Login to get access

Abstract

Purpose

To understand the long-term surgical outcomes and prognostic factors for the operative treatment of cervical myelopathy (CM) in patients with athetoid cerebral palsy (ACP).

Methods

We retrospectively reviewed 24 patients with ACP who underwent surgery for CM at our hospital between March 2002 and June 2008. All patients had more than 5 years follow-up. Anterior fusion (11 patients), posterior fusion (1 patient), or combined anterior and posterior (AP) fusion (7 patients) and C1-2 fusion (5 patients) surgeries were performed. Surgical outcomes (average follow-up 102 months), as assessed using modified JOA (mJOA) scores, the Neck Disability Index (NDI), and a visual analog scale (VAS) were compared between the preoperative and postoperative states.

Results

Preoperatvie cervical kyphosis decreased mJOA scores significantly. Long-term follow-up clinical outcomes demonstrated that 10 patients showed favorable (excellent and good) outcomes and 11 patients had non-favorable (fair and worse) outcomes. According to the mJOA scores, patients showed postoperative improvement (7.10–10.45). NDI decreased from 68.46 to 31.66. A second operation was done in seven cases due to instrument failure, progressive kyphotic deformities and adjacent segment degeneration. A preoperative botulinum toxin injection significantly decreased (p < 0.05) the incidence of a second operation.

Conclusions

Patients with ACP have high incidence of instrument failure. Strong surgical fixation, bone fusion and perioperative immobilizations using botulinum toxin injection should be carefully planned preoperatively.
Literature
1.
2.
Singh K, Samartzis D, Somera AL, An HS (2008) Cervical kyphosis and thoracic lordoscoliosis in a patient with cerebral palsy. Orthopedics 31:276 orthopedics.26417 [pii]PubMedCrossRef
3.
4.
Ebara S, Harada T, Yamazaki Y, Hosono N, Yonenobu K, Hiroshima K, Ono K (1989) Unstable cervical spine in athetoid cerebral palsy. Spine 14:1154–1159PubMedCrossRef
5.
Reese ME, Msall ME, Owen S, Pictor SP, Paroski MW (1991) Acquired cervical spine impairment in young adults with cerebral palsy. Dev Med Child Neurol 33:153–158PubMedCrossRef
6.
Azuma S, Seichi A, Ohnishi I, Kawaguchi H, Kitagawa T, Nakamura K (2002) Long-term results of operative treatment for cervical spondylotic myelopathy in patients with athetoid cerebral palsy: an over 10-year follow-up study. Spine 27:943–948 (discussion 948)PubMedCrossRef
7.
Basciani M, Intiso D, Cioffi RP, Tonali P (2000) Preoperative treatment with botulinum A toxin in patients with cervical disk herniation secondary to dystonic cerebral palsy. Neurol Sci 21:63PubMedCrossRef
8.
Racette BA, Lauryssen C, Perlmutter JS (1998) Preoperative treatment with botulinum toxin to facilitate cervical fusion in dystonic cerebral palsy. Report of two cases. J Neurosurg 88:328–330PubMedCrossRef
9.
Wong AS, Massicotte EM, Fehlings MG (2005) Surgical treatment of cervical myeloradiculopathy associated with movement disorders: indications, technique, and clinical outcome. J Spinal Disord Tech 18(Suppl):S107–S114 00024720-200502001-00016 [pii]PubMedCrossRef
10.
Fujimura Y, Nishi Y, Nakamura M, Toyama Y, Suzuki N (1997) Long-term follow-up study of anterior decompression and fusion for thoracic myelopathy resulting from ossification of the posterior longitudinal ligament. Spine 22:305–311PubMedCrossRef
11.
Ebara S, Yamazaki Y, Harada T, Hosono N, Morimoto Y, Tang L, Seguchi Y, Ono K (1990) Motion analysis of the cervical spine in athetoid cerebral palsy. Extension–flexion motion. Spine 15:1097–1103PubMedCrossRef
12.
Harada T, Ebara S, Anwar MM, Okawa A, Kajiura I, Hiroshima K, Ono K (1996) The cervical spine in athetoid cerebral palsy. A radiological study of 180 patients. J Bone Joint Surg Br 78:613–619PubMed
13.
Hojo M, Nakahara I, Tanaka M, Oda Y, Kikuchi H (1994) Surgical treatment of atlanto-axial dislocation in a patient of athetoid cerebral palsy. No Shinkei Geka 22:887–891PubMed
14.
Tsirikos AI, Chang WN, Shah SA, Miller F (2003) Acquired atlantoaxial instability in children with spastic cerebral palsy. J Pediatr Orthop 23:335–341PubMed
15.
Onari K (2000) Surgical treatment for cervical spondylotic myelopathy associated with athetoid cerebral palsy. J Orthop Sci 5:439–448PubMedCrossRef
16.
Onari K, Kondo S, Mihara H, Iwamura Y (2002) Combined anterior–posterior fusion for cervical spondylotic myelopathy in patients with athetoid cerebral palsy. J Neurosurg 97:13–19PubMed
17.
18.
White AA 3rd, Panjabi MM (1978) The basic kinematics of the human spine. A review of past and current knowledge. Spine (Phila Pa 1976) 3:12–20CrossRef
19.
Kidron D, Steiner I, Melamed E (1987) Late-onset progressive radiculomyelopathy in patients with cervical athetoid–dystonic cerebral palsy. Eur Neurol 27:164–166PubMedCrossRef
20.
Polk JL, Maragos VA, Nicholas JJ (1992) Cervical spondylotic myeloradiculopathy in dystonia. Arch Phys Med Rehabil 73:389–392 0003-9993(92)90016-P [pii]PubMedCrossRef
21.
Mikawa Y, Watanabe R, Shikata J (1997) Cervical myelo-radiculopathy in athetoid cerebral palsy. Arch Orthop Trauma Surg 116:116–118PubMedCrossRef
22.
Epstein NE (1999) Circumferential cervical surgery for spondylostenosis with kyphosis in two patients with athetoid cerebral palsy. Surg Neurol 52:339–344 S0090-3019(99)00117-2 [pii]PubMedCrossRef
23.
Holly LT, Matz PG, Anderson PA, Groff MW, Heary RF, Kaiser MG, Mummaneni PV, Ryken TC, Choudhri TF, Vresilovic EJ, Resnick DK (2009) Clinical prognostic indicators of surgical outcome in cervical spondylotic myelopathy. J Neurosurg Spine 11:112–118. doi:10.​3171/​2009.​1.​SPINE08718 PubMedCrossRef
24.
Graham HK (2001) Botulinum toxin type A management of spasticity in the context of orthopaedic surgery for children with spastic cerebral palsy. Eur J Neurol 8(Suppl 5):30–39 036 [pii]PubMedCrossRef
25.
26.
Iwamuro H, Takahashi H, Ide K, Nakauchi J, Taniguchi M (2003) Peri-operative treatment with botulinum A toxin prior to posterior cervical decompression in a case with cervical spondylosis caused by spasmodic torticollis secondary to cerebral palsy. No Shinkei Geka 31:1015–1020PubMed
27.
Ueda Y, Yoshikawa T, Koizumi M, Iida J, Miyazaki K, Nishiyama S, Matsuyama E, Kugai A, Takeshima T, Takakura Y (2005) Cervical laminoplasty combined with muscle release in patients with athetoid cerebral palsy. Spine 30:2420–2423 00007632-200511010-00013 [pii]PubMedCrossRef
Metadata
Title
Long-term surgical outcomes of cervical myelopathy with athetoid cerebral palsy
Authors
Keung Nyun Kim
Poong Gee Ahn
Mi Jung Ryu
Dong Ah Shin
Seong Yi
Do Heum Yoon
Yoon Ha
Publication date
01-07-2014
Publisher
Springer Berlin Heidelberg
Published in
European Spine Journal / Issue 7/2014
Print ISSN: 0940-6719
Electronic ISSN: 1432-0932
DOI
https://doi.org/10.1007/s00586-013-3119-4

Other articles of this Issue 7/2014

European Spine Journal 7/2014 Go to the issue

Original Article

Influence of age and sagittal balance of the spine on the value of the pelvic incidence

Original Article

Impact of spinal alignment and back muscle strength on shoulder range of motion in middle-aged and elderly people in a prospective cohort study

Letter to the Editor

A comparison of spinal anesthesia characteristics following intrathecal bupivacaine or levobupivacaine in lumbar disc surgery

Original Article

Early neurological recovery course after surgical treatment of cervical spondylotic myelopathy: a prospective study with 2-year follow-up using three different functional assessment tests

Original Article

Clinical applicability of magnetic resonance imaging in acute spinal cord trauma

Editorial

Spinal balance: the toll of bipedalism or the “French Connection”