Cervical kyphosis and thoracic lordoscoliosis in a patient with cerebral palsy.

Abstract

The management of cerebral palsy and spinal deformity can be challenging for spine surgeons. Scoliosis is the most common spinal deformity associated with cerebral palsy; however, the development of thoracic lordoscoliosis is rare. Cervical kyphosis in cerebral palsy patients is associated primarily with athetoid cerebral palsy. This article presents a case of progressive myelopathy and concurrent cervical kyphosis and thoracic lordoscoliosis in a 17-year-old spastic quadriplegic cerebral palsy patient who underwent 2-stage treatment. In the first stage, the cervical spine was managed with a 2-level cervical corpectomy of C5 and C6, with multilevel laminectomies, lateral mass plating, and wire fixation. In the second stage 3 months later, the thoracic deformity was corrected through a combined anterior spinal release of the thoracic spine with posterior spinal segmental instrumentation and sublaminar wiring. Postoperatively, the patient successfully returned to independent ambulation.