Shi-Gang Xu1, Lin Xu, Xu Cao, Yong Jiao. 1. Department of Orthopaedics, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing 100700, China. dongzhimen700@sina.com
Abstract
OBJECTIVE: To retrospectively review the results of cervical perivascular sympathectomy (CPVS) in treating athetoid cerebral palsy and discuss the possible mechanism of the surgery. METHODS: From 1998 to 2006,560 patients with athetoid cerebral palsy were treated with cervical perivascular sympathectomy and all had periodical follow-up at 1 week, 6 months and 1 year postoperatively. Among the 560 patients,there were 391 boys and 169 girls. The age at operation was from 3 to 25 years old with an average of 10.7 years. RESULTS: At 1 year follow-up postoperatively, among the 560 cases, athetoid movement of the neck and head improved in 308 patients (55%), the movement of the hand and fingers improved in 403 patients (72%), standing and gait improved in 229 patients (41%), muscle tone reduced in 185 patients (33%), salvation reduction appeared in 252 patients (45%), eyeball movement improved in 174 patients (31%), speaking improved in 251 patients (45%); 310 patients (55%) agreed that the operation had curative effect for the patients. Short-term follow up results was better than long-term follow up results. CONCLUSION: Primary results showed that CPVS had a curative effect on athetoid cerebral palsy, especially in improving athetoid movement of the neck and head, hand and fingers, standing and gait, speaking ability, eye-ball movement and so on. The possible mechanism of the CPVS in the treatment of athetoid cerebral palsy might be reducing the excitability of sympathetic nerve, improving microcirculation of the brain and eventually activating potential neurons. Long-term follow up is necessary.
OBJECTIVE: To retrospectively review the results of cervical perivascular sympathectomy (CPVS) in treating athetoid cerebral palsy and discuss the possible mechanism of the surgery. METHODS: From 1998 to 2006,560 patients with athetoid cerebral palsy were treated with cervical perivascular sympathectomy and all had periodical follow-up at 1 week, 6 months and 1 year postoperatively. Among the 560 patients,there were 391 boys and 169 girls. The age at operation was from 3 to 25 years old with an average of 10.7 years. RESULTS: At 1 year follow-up postoperatively, among the 560 cases, athetoid movement of the neck and head improved in 308 patients (55%), the movement of the hand and fingers improved in 403 patients (72%), standing and gait improved in 229 patients (41%), muscle tone reduced in 185 patients (33%), salvation reduction appeared in 252 patients (45%), eyeball movement improved in 174 patients (31%), speaking improved in 251 patients (45%); 310 patients (55%) agreed that the operation had curative effect for the patients. Short-term follow up results was better than long-term follow up results. CONCLUSION: Primary results showed that CPVS had a curative effect on athetoid cerebral palsy, especially in improving athetoid movement of the neck and head, hand and fingers, standing and gait, speaking ability, eye-ball movement and so on. The possible mechanism of the CPVS in the treatment of athetoid cerebral palsy might be reducing the excitability of sympathetic nerve, improving microcirculation of the brain and eventually activating potential neurons. Long-term follow up is necessary.