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Journal of Korean Neurosurgical Society 2008;43(6): 294-299.
doi: https://doi.org/10.3340/jkns.2008.43.6.294
Surgical Treatments for Cervical Spondylotic Myelopathy Associated with Athetoid Cerebral Palsy.
Yong Jeon Lee, Dong Sup Chung, Jong Tae Kim, Ho Jin Bong, Young Min Han, Young Sup Park
Department of Neurosurgery, Our Lady of Mercy Hospital, Catholic University, Incheon, Korea. kjtns@olmh.cuk.ac.kr
To evaluate the clinical characteristics and surgical outcomes of the patients with cervical spondylotic myelopathy associated with athetoid cerebral palsy. METHODS: The authors reviewed the clinical and neurodiagnostic findings, surgical managements and outcomes in six consecutive patients with cervical spondylotic myelopathy associated with athetoid cerebral palsy who had been treated with surgical decompression and fusion procedures between January 1999 and December 2005. The mean age of the 6 patients (four women and two men) at the time of surgery was 42.8 years (range, 31-55 years). The mean follow-up period was 56.5 months (range, 17-112 months). The neurological outcome was evaluated before and after operations (immediately, 6 months after and final follow-up) using grading systems of the walking ability, brachialgia and deltoid power. RESULTS: At immediate postoperative period, after 6 months, and at final follow-up, all patients showed apparent clinical improvements in walking ability, upper extremity pain and deltoid muscle strength. Late neurological deterioration was not seen during follow-up periods. There were no serious complications related to surgery. CONCLUSION: Surgical decompression and stabilization in patients with cervical spondylotic myelopathy associated with athetoid cerebral palsy have been challenging procedure up to now. Our results indicate that early diagnosis and appropriate surgical procedure can effectively improve the clinical symptoms and neurological function in patients with cervical spondylotic myelopathy and athetoid cerebral palsy, even in those with severe involuntary movements.
Key Words: Cerebral Palsy; Spinal Cord Compression; Decompression; Instrumentation
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