Long-Term Results of Operative Treatment for Cervical Spondylotic Myelopathy in Patients With Athetoid Cerebral Palsy

Abstract

Long-term follow-up evaluation is essential in any type of operation, particularly with patients with athetoid cerebral palsy who often undergo this operation in their 30s or 40s.

Cervical myelopathy in athetoid and dystonic cerebral palsy: retrospective study and literature review

“…The presence and the evolution of preoperative vesicospincteric problems were rarely reported which we think are of great importance in disability [2,9,16,19,22,23]. Of the six patients who newly developed or had a worsening of sphincteric control, only three recovered their previous function.…”

“…The majority of authors use the JOA score to evaluate the functional condition of their patients, especially the motor items [2,23]. According to this score, all of our patients improved functionally with a mean gain of 1.5 points (0.5-2.5) but this score does not take into consideration the specificity of athetoid or dystonic movements that disrupt the voluntary command therefore rendering the results inaccurate.…”

“…Surgical treatment always requires spinal cord decompression by anterior approach (corporectomy and discectomy) or by posterior approach (laminectomy and laminoplasty) [2,7,9,13,17,19,22,23]. No isolated cervical laminectomy should ever be performed alone [2,11,14,17,18].…”

“…Spinal fusion increases strains on adjacent levels, predisposing to adjacent level instability or stenosis [2,11,13]. Azuma et al [2] observed 80 and 60% of neurological and radiological deterioration, respectively, in a 15-year follow-up study with spinal fusion. Therefore, he recommended performing laminoplasty without spinal fusion but adjacent degenerative modifications developed as well.…”

Artrodesis combinada anterior y posterior en paciente con parálisis cerebral atetósica que desarrolla mielopatía cervical degenerativa: Caso clínico y revisión de la literatura

“…Si bien la cervicoartrosis en este tipo de pacientes es precoz, y por lo tanto sus síntomas se produzcan en edades 3,15 , debido a la patología de base, muchas veces los síntomas de la mielopatía y de la radiculopatía pasan desapercibidos, y, por lo tanto, el diagnóstico es tardío. En el caso clínico descrito, por ejemplo, la paciente afectada por PCI lleva una vida autónoma (vive sola en un piso) e incluso tiene un papel activo en el mundo laboral.…”