Mielopatía espondilítica cervical en pacientes de parálisis cerebral. (I)

"Mielopatía spondilítica cervical en pacientes con parálisis cerebral atetósica."

Aurélie Durufléa, Sabine Pétrillia, Jean-Luc Le Guietb, Gilles Brassierc, Benoit Nicolasd, Hélène Le Talleca and Philippe Gallien, , a a Department of Physical Therapy and Rehabilitation, University Hospital of Rennes, CHRU Pontchaillou, 2, rue Henri Le Guilloux, 35033, Rennes cedex, France b Rehabilitation center of Kerpape, 56275, Ploemeur cedex, France c Department of Neurosurgery, University Hospital of Rennes, 2, rue Henri Le Guilloux, 35033, Rennes cedex, France d Rehabilitation center, Notre Dame de Lourde, 54, rue St Hélier, 35000, Rennes, France Received 14 October 2003; accepted 20 May 2004. Available online 23 July 2004.

Abstract

We herein report five cases of cerebral palsy athetosic patients with spondyloid cervical myelopathy. Four of them underwent decompressive surgery. The level of cervicarthrosis differs from a control population with a more frequent osteoarthritis on the lower cervical spine. The diagnosis of spondylotic cervical myelopathy is frequently overlooked because of the insidious progression of neurologic disorders and of the pre-existent neurological handicap. Depressive syndrome is often evoked in such a situation, and thus responsible for a delay of diagnosis. The presence of an hypersignal in T2 MRI sequences is still controversial. For some authors it is an indication for surgery, which is the treatment with the best functional results.

Conclusion. – Cervical spondylotic myelopathy must be evoked in patients with athetoid cerebral palsy who complain about a decrease of their functional ability.

Joint Bone Spine Volume 72, Issue 3 , May 2005, Pages 270-274.