Lumbar Spinal Disorders in Patients With Athetoid Cerebral Palsy

Sakai, Toshinori; Yamada, Hidehiro; Nakamura, Taro; Nanamori, Kazuhisa; Kawasaki, Yoshiaki; Hanaoka, Naoyoshi; Nakamura, Eijiro; Uchida, Ken; Goel, Vijay K.; Vishnubhotla, Lakshmi; Sairyo, Koichi

doi:10.1097/01.brs.0000197650.77751.80

Cited by 42 publications

(31 citation statements)

References 23 publications

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“…Nine patients showed spondylolysis at multiple levels in the present study with prevalence almost equal to that in a CT-based study [16] but lower than that in another study [19]. This could have been due to the greater accuracy of CT in depicting pars fractures as well as the different population of patients being evaluated.…”

Section: Discussioncontrasting

confidence: 66%

“…Multilevel spondylolysis has been described by some authors [1920], and a high prevalence of multilevel spondylolysis was observed in a radiographic-based study [19]. Nine patients showed spondylolysis at multiple levels in the present study with prevalence almost equal to that in a CT-based study [16] but lower than that in another study [19].…”

Section: Discussionsupporting

confidence: 44%

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Facture of the Pars Interarticularis with or without Spondylolisthesis in an Adult Population in a Developing Country: Evaluation by Multidetector Computed Tomography

et al. 2017

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Study DesignDescriptive cross-sectional study.PurposeTo determine the prevalence of lumbar spondylolysis and spondylolisthesis in a general adult population unrelated to lower back pain as evaluated by multidetector computed tomography.Overview of LiteratureThere is a significant paucity of information related to the prevalence of spondylolysis and spondylolisthesis and its degenerative changes in a general adult population unrelated to lower back pain in developing countries.MethodsA retrospective study was conducted on abdominopelvic computed tomography (CT) scans performed between January 1st 2015 and December 31st 2015 for various clinical indications. Patients with lower back pain, with a history of trauma or road traffic accident, or referred from orthopedic or neurosurgery departments were excluded to avoid any bias. CT scans were reviewed in axial, sagittal, and coronal planes using bone window settings for evaluating spondylolysis and spondylolisthesis.ResultsOf 4,348 patients recruited, spondylolysis and spondylolisthesis were identified in 266 (6.1%) and 142 (3.3%) patients, respectively. Age was significantly higher in both spondylolysis and spondylolisthesis patients than in those without spondylolysis and spondylolisthesis (47.19±15.45 vs. 42.5±15.96, p<0.001 and 53.01±15.31 vs. 42.44±15.88, p<0.001, respectively). Gender was significantly associated with spondylolisthesis (p=0.029) but not spondylolysis. Of patients who were >60 years old, both spondylolysis (p=0.018) and spondylolisthesis (p=0.025) were significantly more prevalent in females.ConclusionsThe prevalence of pars interarticularis fracture observed higher with gradual increase in the prevalence with advancing age. In particular, preponderance was significantly higher among older females.

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Section: Discussioncontrasting

confidence: 66%

Section: Discussionsupporting

confidence: 44%

Facture of the Pars Interarticularis with or without Spondylolisthesis in an Adult Population in a Developing Country: Evaluation by Multidetector Computed Tomography

et al. 2017

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“…In a series of 143 patients who had never walked and in whom the condition of CP dominated, no cases of spondylolysis or spondylolisthesis were detected radiographically 50 . Dystonic involuntary movements through the lumbosacral spine, particularly into extension and axial rotation, appear to contribute to the higher incidences of spondylolysis in this population 45,51 Figure 5. displays spondylolysis bilateral at the L5 S1 level in a 35‐year‐old ambulatory male with cerebral palsy, spastic diplegic type.…”

Section: Spondylolysismentioning

confidence: 95%

“…Reports in the literature have identified the prevalence of spondylolysis in weight‐bearing adults with CP with or without dystonia as between 21% and 30% 21,45,46 . This prevalence may be higher in individuals who have undergone selective posterior rhizotomy and with associated increased anterior pelvic tilt 47–49 .…”

Section: Spondylolysismentioning

confidence: 99%

Cerebral palsy lifetime care – four musculoskeletal conditions

Murphy

2009

Develop Med Child Neuro

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Cerebral palsy (CP) has always been considered a static condition in the neurological sense. Secondary and associated conditions that occur in the patient with CPcan progress over time and cause unwanted sequelae. This paper discusses four musculoskeletal conditions that present across the lifetime and can lead to progressive loss of function in the patient with CP. Patella alta can be particularly painful in the early adult years, limiting mobility particularly when associated with crouch gait. Adults with lower‐extremity weight‐bearing status having hip dysplasia, progressive over time, often develop pain and severe degenerative arthritis, with or without arthrodesis. Spondylolysis, particularly at the L5 S1 level, is fairly common in the ambulatory adult with diplegia and may, if not diagnosed early, progress to spondylolisthesis. Cervical stenosis appears to be more prevalent in adults with spastic quadriparesis and dystonia and is often associated with myelomalacia and/or radiculopathy. All four of these conditions may be lessened, or even prevented, with intervention and diagnosis in the younger years. Possible interventions and outcomes over time are discussed in the context of multidisciplinary team management of the individual with CP.

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“…Biomechanically and clinically, repetitive lumbar extensions and rotations that are required for athletic activity were regarded as the main risk factor [3,4]. Most of the time, the stress fracture occurs in the adolescent period and is a frequent cause of low back pain (LBP) in teenagers and young adults, especially those who are involved in sports [5][6][7].…”

Section: Introductionmentioning

confidence: 99%

Clinical features of patients with pars defects identified in adulthood

Sakai

Goda

Tezuka

et al. 2015

Eur J Orthop Surg Traumatol

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Approximately 90 % of patients with terminal-stage spondylolysis that was first diagnosed in adulthood involved the L5. Also, about 40 % had no history of athletic activity or experience of LBP during their growth period. In addition, only some patients with L5 spondylolysis had SBO, and all but one of these patients was male. This suggests that male patients with L5 spondylolysis may have some congenital predisposition.

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Lumbar Spinal Disorders in Patients With Athetoid Cerebral Palsy

Abstract: The athetoid involuntary movements in CP patients may cause stress-related lumbar disorders. Especially, combined extension and rotation due to the involuntary trunk motion may contribute to the high incidence of spondylolysis.

Cited by 42 publications

References 23 publications

Facture of the Pars Interarticularis with or without Spondylolisthesis in an Adult Population in a Developing Country: Evaluation by Multidetector Computed Tomography

Facture of the Pars Interarticularis with or without Spondylolisthesis in an Adult Population in a Developing Country: Evaluation by Multidetector Computed Tomography

Cerebral palsy lifetime care – four musculoskeletal conditions

Clinical features of patients with pars defects identified in adulthood

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