Lee, Yong-Jeon
(Department of Neurosurgery Our Lady of Mercy Hospital Catholic University)
,
Chung, Dong-Sup
(Department of Neurosurgery Our Lady of Mercy Hospital Catholic University)
,
Kim, Jong-Tae
(Department of Neurosurgery Our Lady of Mercy Hospital Catholic University)
,
Bong, Ho-Jin
(Department of Neurosurgery Our Lady of Mercy Hospital Catholic University)
,
Han, Young-Min
(Department of Neurosurgery Our Lady of Mercy Hospital Catholic University)
,
Park, Young-Sup
(Department of Neurosurgery Our Lady of Mercy Hospital Catholic University)
Objective : 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 pati...
Objective : 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.
Objective : 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.
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제안 방법
She presented with gradual deterioration of the ambulation ability, severe pain and weakness at the both shoulders for over 30 months. Combined anterior and posterior decompression with instrumentations were done for the C1-2 instability and multilevel cervical stenosis (Occiput-C1 -2, C4-T1), and then halovest application was done for 4 months. There were no screw loosening and pin site infection of the halovest.
대상 데이터
1. This 39-year-old woman developed progressive q니adriparesis and intractable upper extremity pain in the one month before admission. An preoperative lateral x-ray (A) and MR sagittal image (B) of the cervical spine demonstrate degenerative changes and severe cord compression at C3-4, C5-6, and C6-7.
2. This case was a 44-year-old woman with cerebral palsy. She presented with gradual deterioration of the ambulation ability, severe pain and weakness at the both shoulders for over 30 months.
이론/모형
Ambulation was classified into three grades: Grade 1, able to ambulate without help; Grade 2, a비e to ambulate using a cane or other assistance; and Grade 3, unable to ambulate and requiring a wheelchair19\ Upper extremity pain was rated according to the Denis Pain Scale^. Ddt&d muscle strength was evaluated using Manual Mils시e lest (MMT). Neiilologic evaluations were evaluated by estimation of the upper and lower extremity motor power, upper extremity pain.
Neiilologic evaluations were evaluated by estimation of the upper and lower extremity motor power, upper extremity pain. Each parameters were assessed using the walking ability grading (on lower extremity motor power), deltoid power grading by the MMT (on upper extremity power) and upper extremity pain scale (Denis pain scale). Surgery-related results were assessed as excellent (improvement of more than two grades), good (im provement of one grade), or poor (no improvement or deterioration).
성능/효과
Each parameters were assessed using the walking ability grading (on lower extremity motor power), deltoid power grading by the MMT (on upper extremity power) and upper extremity pain scale (Denis pain scale). Surgery-related results were assessed as excellent (improvement of more than two grades), good (im provement of one grade), or poor (no improvement or deterioration).
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