J Korean Neurosurg Soc.  2018 Mar;61(2):243-250. 10.3340/jkns.2017.0303.011.

Comparison of Morphological Characteristics of the Subaxial Cervical Spine between Athetoid Cerebral Palsy and Normal Control

Affiliations
  • 1Department of Neurosurgery, Wiltse Memorial Hospital, Suwon, Korea.
  • 2Department of Neurosurgery, St. Vincent’s Hospital, College of Medicine, The Catholic University of Korea, Suwon, Korea. jatagi15@gmail.com

Abstract


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.

Keyword

Cerebral palsy; Cervical spine; Morphology; Motion

MeSH Terms

Body Mass Index
Cerebral Palsy*
Humans
Retrospective Studies
Sclerosis
Scoliosis
Spine*
Zygapophyseal Joint

Figure

  • Fig. 1 A schematic diagram of the lateral mass, pedicle and vertebral foramen asymmetry parameters measured on computed tomography scans. LMAH : lateral mass anterior height, LMT : lateral mass thickness, LMPH : lateral mass posterior height, a : distance from the midline to right vertebral foramen, b : distance from the midline to left vertebral foramen, POD : pedicle outer diameter, LMW : lateral mass width, PID : pedicle inner diameter.

  • Fig. 2 Dynamic lateral plain X-rays for cervical dynamic motion range. The O–C2A represents the angle between McGregor’s line and the inferior endplate of C2. The C2–7A represents the angle between the inferior endplates of C2 and C7. The O–C7A represents the angle between McGregor’s line and the inferior endplate of C7.

  • Fig. 3 Parasagittal computed tomography reconstruction images show lateral mass height of cerebral palsy group (A) is smaller than that in the control group (B) on all cervical levels.

  • Fig. 4 Axial computed tomography image shows the osteosclerotic changes of the right pedicle (arrow).


Reference

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