Symptomatic cervical spinal stenosis in spastic cerebral palsy

Area of Science:

• Neurology
• Spinal Cord Medicine
• Cerebral Palsy Research

Background:

• Cerebral palsy (CP) is a complex neurological disorder affecting movement and posture.
• Cervical spinal stenosis (CSS) is a condition of spinal cord compression in the neck.
• The prevalence and characteristics of CSS in adults with CP are not well-defined.

Purpose of the Study:

• To determine the prevalence of symptomatic cervical spinal stenosis (CSS) in an adult population with cerebral palsy (CP).
• To identify patient characteristics associated with CSS in this cohort.
• To describe the clinical presentations and common levels of stenosis in affected individuals.

Main Methods:

• A cross-sectional study was conducted on adults (age >18 years) diagnosed with CP between 2006 and 2016.
• Patient demographics, comorbidities, GMFCS level, CP type, and medication history were compared between patients with and without CSS.
• Clinical presentations and levels of cervical spine stenosis were documented.

Main Results:

• Symptomatic CSS was identified in 7.5% of the 424 adult CP patients studied.
• Individuals with CSS were significantly older (mean age 54.5 years) and had higher BMIs compared to those without CSS.
• Common symptoms included upper-extremity issues (73%), ambulation decline (70%), neck pain (53%), and incontinence (30%), with C5-C6, C4-C5, and C6-C7 being the most frequent stenosis levels.

Conclusions:

• Symptomatic CSS is a notable condition in adults with CP, affecting 7.5% of the cohort.
• The diagnosis of CSS in CP patients can be challenging due to overlapping symptoms like spasticity and gait abnormalities.
• Developing screening guidelines and maintaining a high index of suspicion for CSS in CP patients with new neurological changes are recommended.