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Surgical outcomes of cervical myelopathy in patients with athetoid cerebral palsy

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European Journal of Orthopaedic Surgery & Traumatology Aims and scope Submit manuscript

Abstract

Purpose

Surgical treatment for cervical myelopathy with athetoid cerebral palsy remains unestablished. Instrumented fusion is reported to have good clinical results; however, there are no data of decompression surgery for this pathology in recent years. This study aimed to assess the surgical outcomes of laminoplasty with or without posterior instrumented fusion for cervical myelopathy in patients with athetoid cerebral palsy.

Methods

A multi-centre surgical series of patients with cervical myelopathy and athetoid cerebral palsy were enrolled in this study. All patients showed symptoms and signs suggestive of cervical myelopathy and underwent laminoplasty with or without instrumented fusion. The Japanese Orthopaedic Association (JOA) score, Barthel index (BI), and changes in the C2–C7 sagittal Cobb angle in the lateral plain radiograph were analysed.

Results

There were 25 patients (16 men and 9 women; mean age, 54.4 ± 10.8 years) with cervical myelopathy and athetoid cerebral palsy who underwent surgical treatment. The mean follow-up period was 41.9 ± 35.6 months. Overall, the BI significantly improved after surgery, whereas the JOA score and C2–C7 angle did not improve postoperatively. The recovery rate of the JOA score in the laminoplasty group was significantly higher than that of the fusion group (P = 0.02).

Conclusions

Cervical laminoplasty with or without instrumented fusion for treating cervical myelopathy due to athetoid cerebral palsy is effective in improving activities of daily living. Cervical laminoplasty may be an effective and less invasive surgical method for selective patients, especially for those with small involuntary movements and no remarkable cervical kyphosis nor instability.

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Availability of data and material

The data that support the findings of this study are available from the corresponding author (T.N.) upon reasonable request.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551, Japan

    Takahiro Harada, Toshio Nakamae, Naosuke Kamei, Yuji Tsuchikawa, Taiki Morisako, Toshiaki Maruyama & Nobuo Adachi

  2. Department of Orthopaedic Surgery, JA Hiroshima General Hospital, Hiroshima, Japan

    Yoshinori Fujimoto

  3. Department of Orthopaedic Surgery, Hiroshima City Asa Citizens Hospital, Hiroshima, Japan

    Hideki Manabe & Yasushi Fujiwara

  4. Department of Orthopaedic Surgery, JR Hiroshima Hospital, Hiroshima, Japan

    Nobuhiro Tanaka

Authors
  1. Takahiro Harada
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  2. Toshio Nakamae
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  3. Naosuke Kamei
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  4. Yoshinori Fujimoto
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  5. Hideki Manabe
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  6. Nobuhiro Tanaka
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  7. Yasushi Fujiwara
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  8. Kiyotaka Yamada
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  9. Yuji Tsuchikawa
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  10. Taiki Morisako
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  11. Toshiaki Maruyama
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  12. Nobuo Adachi
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Contributions

TH wrote and prepared the manuscript, TN designed this study, and all authors have read, reviewed, and approved the article.

Corresponding author

Correspondence to Toshio Nakamae.

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The authors declare that they do not have any conflict of interest.

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This study was approved by our institutional review board.

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All patients provided informed consent to participate.

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All patients provided informed consent for publication.

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Harada, T., Nakamae, T., Kamei, N. et al. Surgical outcomes of cervical myelopathy in patients with athetoid cerebral palsy. Eur J Orthop Surg Traumatol 32, 1283–1289 (2022). https://doi.org/10.1007/s00590-021-03109-7

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  • DOI: https://doi.org/10.1007/s00590-021-03109-7

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