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

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.

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

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.

Intensive Insulin Therapy after Decompression Surgery for Severe Traumatic Brain Injury / 대한신경손상학회지

OBJECTIVE: The purpose of this study was to compare intensive insulin therapy and conventional therapy in terms of ventilator days, neurosurgical intensive care unit (NSICU) stay, Glasgow Outcome Scale (GOS), and complications for patients with a severe traumatic brain injury (TBI) who underwent decompressive craniectomy. METHODS: Patients who had a TBI and a Glasgow Coma Scale (GCS) score < or =8, and who had been treated with a unilateral or bilateral decompressive craniectomy were enrolled. Twenty-three patients were treated with intensive insulin therapy targeting 80-120 mg/dL of blood glucose level. For comparison, 17 patients with conventional insulin therapy (<200 mg/dL) were extracted from the historical data. RESULTS: There was no statistically significant difference in terms of sex, age, GCS at admission, diagnosis of TBI, and history of diabetes. There was no statistically significant difference between the conventional and intensive groups with respect to total days of mechanical ventilation, NSICU days, GOS, and pneumonia. Hypoglycemic episodes developed more frequently in the intensive insulin therapy group than in the conventional therapy group. CONCLUSION: Intensive insulin therapy with our protocol cannot be recommended over conventional therapy in patients with severe TBI.