THE CERVICAL SPINE IN ATHETOID CEREBRAL PALSY

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  • T. Harada
    Osaka Police Hospital, 10–31 Kitayama-cho, Tennoji-ku, Osaka 543, Japan.
  • S. Ebara
    Department of Orthopaedic Surgery, Osaka University Medical School, 2-2 Yamadaoka, Suita 565, Osaka, Japan.
  • M. M. Anwar
    Department of Orthopaedics and Trauma, Worcester Royal Infirmary NHS Trust, Newton Road, Worcester WR5 1JG, UK.
  • A. Okawa
    Bobath Memorial Hospital, 1-6-5 Higashinakahama, Joto-ku, Osaka 536, Japan.
  • I. Kajiura
    Bobath Memorial Hospital, 1-6-5 Higashinakahama, Joto-ku, Osaka 536, Japan.
  • K. Hiroshima
    Osaka National Hospital, 2-1-14 Hoenzaka, Chuo-ku, Osaka 540, Japan.
  • K. Ono
    Osaka Koseinenkin Hospital, 4-2-78 Fukushima, Fukushima-ku, Osaka 553, Japan.

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  • A RADIOLOGICAL STUDY OF 180 PATIENTS

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<jats:p> We have reviewed the cervical spine radiographs of 180 patients with athetoid cerebral palsy and compared them with those of 417 control subjects. </jats:p><jats:p> Disc degeneration occurred earlier and progressed more rapidly in the patients, with advanced disc degeneration in 51%, eight times the frequency in normal subjects. At the C3/4 and C4/5 levels, there was listhetic instability in 17% and 27% of the patients, respectively, again six and eight times more frequently than in the control subjects. Angular instability was seen, particularly at the C3/4, C4/5 and C5/6 levels. </jats:p><jats:p> We found a significantly higher incidence of narrowing of the cervical canal in the patients, notably at the C4 and C5 levels, where the average was 14.4 mm in the patients and 16.4 mm in normal subjects. </jats:p><jats:p> The combination of disc degeneration and listhetic instability with a narrow canal predisposes these patients to relatively rapid progression to a devastating neurological deficit. </jats:p>

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