Journal Information
Vol. 22. Issue 3.
Pages 245-250 (January 2011)
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Vol. 22. Issue 3.
Pages 245-250 (January 2011)
Artrodesis combinada anterior y posterior en paciente con parálisis cerebral atetósica que desarrolla mielopatía cervical degenerativa. Caso clínico y revisión de la literatura
Combined Anterior-Posterior arthrodesis en patient with athetoid cerebral palsy who developed spondylotic cervical mielopathy. Case Report and review of literature
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G. Pancucci
Corresponding author
panc82@hotmail.com

Correspondencia: Unidad de patología raquimedular. Servicio de Neurocirugía. Hospital Universitario La Fe. Avenida Campanar, 21. 46009 Valencia, Comunitat Valenciana.
, P. Miranda-Lloret, M.E. Plaza-Ramírez, A. López-González, V. Rovira-Lillo, A. Beltrán-Giner
Unidad de patología raquimedular. Servicio de Neurocirugía. Hospital Universitario La Fe. Valencia
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Resumen

La mielopatía cervical espondiloartrósica es una complicación frecuente en pacientes jóvenes afectados por parálisis cerebral infantil (PCI) que presentan un importante componente distónico y atetósico. Su tratamiento quirúrgico es problemático, caracterizado por tasas elevadas de fracaso precoz de la artrodesis, tanto en los abordajes anteriores como en los posteriores a la columna. Ofrecemos una revisión histórica del tratamiento de la mielopatía cervical en este subgrupo de pacientes, aportando un caso clínico en el que se ha decidido descomprimir y realizar artrodesis tanto por la vía anterior como por la vía cervical posterior, con fijación con tornillos a masas laterales, complementando el tratamiento quirúrgico con la inyección de toxina botulínica en el seguimiento postoperatorio, logrando un buen resultado clínico.

Palabras clave:
Parálisis cerebral atetósica
Espondilosis cervical
Fusión espinal
Descompresión quirúrgica
Summary

Spondylotic cervical mielopathy is a common complication in young patients with Cerebral Child Palsy with an important dystonic and athetoid component. Its surgical treatment is a challenge, due to elevate incidence of early faliure of the arthrodesis, both in anterior and posterior approaches. We report an historical review about the treatment of cervical mielopathy in this subgroup of patients and a clinical case in which we decided to realize decompression and arthtrodesis by a combined anterior and posterior approach, with lateral-mass screw placement, using botulinium toxin injections in the postoperative period, achieving a good clinical outcome.

Key words:
Athetoid cerebral palsy
Cervical spondylosis
Spine fusion
Surgical decompression

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