THE CERVICAL-SPINE IN ATHETOID CEREBRAL-PALSY - A RADIOLOGICAL STUDY OF 180 PATIENTS

We have reviewed the cervical spine radiographs of 180 patients with a thetoid cerebral palsy and compared them with those of 417 control sub jects, Disc degeneration occurred earlier and progressed more rapidly in the patients, with advanced disc degeneration in 51%, eight times t he frequency in normal subjects. At the C3/4 and C4/5 levels, there wa s 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, We found a significantly higher incidence of narrowing of th e cervical canal in the patients, notably at the C4 and C5 levels, whe re the average was 14.4 mm in the patients and 16.4 mm in normal subje cts. The combination of disc degeneration and listhetic instability wi th a narrow canal predisposes these patients to relatively rapid progr ession to a devastating neurological deficit.