Surgical Outcomes of Cervical Myelopathy in Patients with Athetoid Cerebral Palsy: A 5-Year Follow-Up

Watanabe, Kazuyuki; Otani, Koji; Nikaido, Takuya; Kato, Kinshi; Kobayashi, Hiroshi; Yabuki, Shoji; Kikuchi, Shin Ichi; Konno, Shin Ichi

Abstract

STUDY DESIGN: Observational cohort study. PURPOSE: To assess the surgical outcomes of posterior decompression and fusion for cervical myelopathy in patients with athetoid cerebral palsy. OVERVIEW OF LITERATURE: Patients with athetoid cerebral palsy demonstrate involuntary movements and develop severe cervical spondylosis with kyphosis. In these patients, surgery is often performed at an early age because of myelopathy. A few studies have reported about the long-term outcomes of surgical treatment; however, they contain insufficient information.
METHODS
From 2003 to 2008, 13 patients with cervical myelopathy due to athetoid cerebral palsy underwent posterior fusion surgery and were included in this study. The Japanese Orthopaedic Association (JOA) score, neck disability index (NDI), C2-7 angle on radiography, and need for additional surgical treatment were examined at 1 and 5 years postoperatively.
RESULTS
The mean C2-7 angle was âˆ’10.5°±21.1° preoperatively and was corrected to âˆ’2.9°±13.5° immediately postoperatively. This improvement was maintained for 5 years. The JOA score was 9.5±2.5 preoperatively and 12.2±1.7 at the 5-year follow-up. NDI was 17±6.9 preoperatively and 16±7.5 at the 5-year follow-up. Patient satisfaction with surgery on a 100-point scale was 62.2±22.5 at the 5-year follow-up. Three patients needed additional surgery for loosening of screws. These results demonstrate good surgical outcomes for posterior fusion at 5 years.
CONCLUSIONS
Posterior decompression and fusion should be considered a viable option for cervical myelopathy in patients with athetoid cerebral palsy.