Objective : To compare the morphometry of subaxial cervical spine between cerebral palsy (CP) and normal control. Methods : We retrospectively analyzed 72 patients with CP, as well as 72 patients from normal population. The two groups were matched for age, sex, and body mass index. Pedicle, lateral ...
Objective : To compare the morphometry of subaxial cervical spine between cerebral palsy (CP) and normal control. Methods : We retrospectively analyzed 72 patients with CP, as well as 72 patients from normal population. The two groups were matched for age, sex, and body mass index. Pedicle, lateral mass (LM), and vertebral foramen were evaluated using computed tomography (CT) imaging. Pedicle diameter, LM height, thickness, width and vertebral foramen asymmetry (VFA) were measured and compared between the two groups. Cervical dynamic motion, disc and facet joint degeneration were investigated. Additionally, we compared the morphology of LM between convex side and concave side with cervical scoliotic CP patients. Results : LM height was smaller in CP group. LM thickness and width were larger in CP group at mid-cervical level. In 40 CP patients with cervical scoliosis, there were no height and width differences between convex and concave side. Pedicle outer diameter was not statistically different between two groups. Pedicle inner diameter was significantly smaller in CP group. Pedicle sclerosis was more frequent in CP patients. VFA was larger in CP group at C3, C4, and C5. Disc/facet degeneration grade was higher in the CP group. Cervical motion of CP group was smaller than those of the control group. Conclusion : LM morphology of CP patients was different from normal population. Sclerotic pedicles and vertebral foramen asymmetry were more commonly identified in CP patients. CP patients were more likely to demonstrate progressive disc/facet degeneration. This data may provide useful information on cervical posterior instrumentation in CP patients.
Objective : To compare the morphometry of subaxial cervical spine between cerebral palsy (CP) and normal control. Methods : We retrospectively analyzed 72 patients with CP, as well as 72 patients from normal population. The two groups were matched for age, sex, and body mass index. Pedicle, lateral mass (LM), and vertebral foramen were evaluated using computed tomography (CT) imaging. Pedicle diameter, LM height, thickness, width and vertebral foramen asymmetry (VFA) were measured and compared between the two groups. Cervical dynamic motion, disc and facet joint degeneration were investigated. Additionally, we compared the morphology of LM between convex side and concave side with cervical scoliotic CP patients. Results : LM height was smaller in CP group. LM thickness and width were larger in CP group at mid-cervical level. In 40 CP patients with cervical scoliosis, there were no height and width differences between convex and concave side. Pedicle outer diameter was not statistically different between two groups. Pedicle inner diameter was significantly smaller in CP group. Pedicle sclerosis was more frequent in CP patients. VFA was larger in CP group at C3, C4, and C5. Disc/facet degeneration grade was higher in the CP group. Cervical motion of CP group was smaller than those of the control group. Conclusion : LM morphology of CP patients was different from normal population. Sclerotic pedicles and vertebral foramen asymmetry were more commonly identified in CP patients. CP patients were more likely to demonstrate progressive disc/facet degeneration. This data may provide useful information on cervical posterior instrumentation in CP patients.
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문제 정의
As a result, a better understanding of the morphological characteristics of the cervical spine in patients with CP would be important to surgeons performing safer and more accurate instrumentation. The aim of this study was to compare the morphometric subaxial cervical spine between patients with athetoid cerebral palsy and normal population.
가설 설정
Second, although the two groups were matched for age and BMI, the height and weight of CP group was not exactly matched to those of control group. Third, we could not explain the mechanism between cervical morphological changes and involuntary movement in CP patients. Further research, including a closer inspection of the reasons underlying this mechanism, is necessary.
제안 방법
1). Vertebral foramen asymmetry (VFA) was evaluated in C3 to C6 by measuring the difference between the left and right distance from the midline (Fig. 1). C7 was excluded because of absence or hypoplasia of vertebral foramen.
대상 데이터
Both groups underwent standardized axial bone-window CT scanning and a plain X-ray of cervical spine. All CT scans were performed on a Siemens 64-slice CT scanner with 3-mm axial image thickness (Siemens Medical Solutions, Erlangen, Germany). Sagittal and coronal reconstructions were obtained using 1.
Values are presented as mean±standard deviation. Data from 72 subjects. Significant p-value <0.
05, Table 2). Pedicle sclerosis is identified in the 12 patients of the CP group. However there was only one pedicle sclerosis in normal control group (16.
For these patients, we reviewed the preoperative radiologic study. The control group included 32 males and 40 females who checked CT scan due to the mild trauma without any history of cervical spine disease. Each patient in the control group was matched to the age and BMI of a CP patient.
데이터처리
, Somers, NY, USA). For the comparisons of the parameters between the groups, paired t-test for normally distributed continuous variables and Wilcoxon signed-rank test for non-normally distributed continuous variables was used and Fisher exact were used for categorical data. For all statistical tests, p<0.
성능/효과
First, the number of patients included in this study was limited because of the small number of CP cases. Second, although the two groups were matched for age and BMI, the height and weight of CP group was not exactly matched to those of control group. Third, we could not explain the mechanism between cervical morphological changes and involuntary movement in CP patients.
후속연구
We suppose that the decrease of cervical dynamic motion is associated with disc, facet joint degeneration of cervical spine of CP patients. Further research is required for cervical dynamic motion changes in CP patients.
Third, we could not explain the mechanism between cervical morphological changes and involuntary movement in CP patients. Further research, including a closer inspection of the reasons underlying this mechanism, is necessary.
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