Mikawa Y, Watanabe R, Shikata J
Department of Orthopaedic Surgery, Kawasaki Medical School, Okayama, Japan.
Arch Orthop Trauma Surg. 1997;116(1-2):116-8. doi: 10.1007/BF00434115.
Cervical myelopathy complicating athetoid cerebral palsy has not been adequately highlighted in the literature. We report two cases of patients with athetoid cerebral palsy and long histories of involuntary movements who developed cervical myelo-radiculopathy. Dystonic athetoid neck movements may cause excessive axial neck rotation as well as flexion and extension movements of the spine. These repetitive exaggerated movements may result in early degenerative changes of the vertebrae which may enhance the myelo-radiculopathy. The two patients were treated with combined anterior and posterior fusion with satisfactory results. They were bedridden preoperatively but have since started walking with or without a cane. We conclude that combined anterior and posterior fusion is the treatment of choice for severe myelopathy complicating athetoid cerebral palsy.
痉挛性脑瘫并发的颈椎脊髓病在文献中尚未得到充分重视。我们报告两例患有痉挛性脑瘫且有长期不自主运动病史的患者，他们出现了颈髓神经根病。张力障碍性痉挛性颈部运动可能导致颈部过度轴向旋转以及脊柱的屈伸运动。这些反复的过度运动可能导致椎体早期退行性改变，进而加重颈髓神经根病。这两名患者接受了前后联合融合手术，效果满意。他们术前卧床，但术后已开始借助或不借助拐杖行走。我们得出结论，前后联合融合术是治疗痉挛性脑瘫并发严重脊髓病的首选方法。
