Kim Jun Young, Kwon Jae Yeol, Kim Moon Seok, Lee Jeong Jae, Kim Il Sup, Hong Jae Taek
Department of Neurosurgery, Wiltse Memorial Hospital, Suwon, Korea.
Department of Neurosurgery, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Suwon, Korea.
J Korean Neurosurg Soc. 2018 Mar;61(2):243-250. doi: 10.3340/jkns.2017.0303.011. Epub 2018 Feb 28.
To compare the morphometry of subaxial cervical spine between cerebral palsy (CP) and normal control.
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.
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.
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.
比较脑瘫（CP）患者与正常对照者下颈椎的形态学特征。
我们回顾性分析了72例CP患者以及72例正常人群。两组在年龄、性别和体重指数方面进行了匹配。使用计算机断层扫描（CT）成像评估椎弓根、侧块（LM）和椎孔。测量并比较两组的椎弓根直径、LM高度、厚度、宽度以及椎孔不对称性（VFA）。研究颈椎的动态运动、椎间盘和小关节退变情况。此外，我们比较了颈椎侧弯型CP患者凸侧和凹侧LM的形态。
CP组的LM高度较小。在颈椎中部水平，CP组的LM厚度和宽度较大。在40例颈椎侧弯型CP患者中，凸侧和凹侧的高度和宽度没有差异。两组之间椎弓根外径无统计学差异。CP组的椎弓根内径明显较小。CP患者中椎弓根硬化更为常见。在C3、C4和C5水平，CP组的VFA较大。CP组的椎间盘/小关节退变分级更高。CP组的颈椎活动度小于对照组。
CP患者的LM形态与正常人群不同。CP患者中更常见椎弓根硬化和椎孔不对称。CP患者更有可能出现进行性椎间盘/小关节退变。这些数据可能为CP患者颈椎后路内固定提供有用信息。
