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Surgical Strategies for Cervical Deformities Associated With Neuromuscular Disorders

Neurospine 2020년 17권 3호 p.513 ~ 524
이종주, 오성한, 정영하, 박상만, 전형석, 김형철, An Seong-Bae, 신동아, Yi Seong, 김긍년, 윤도흠, 신준재, 하윤,
소속 상세정보
이종주 ( Lee Jong-Joo ) - Bundang Jesaeng General Hospital Department of Neurosurgery
오성한 ( Oh Sung-Han ) - Bundang Jesaeng General Hospital Department of Neurosurgery
정영하 ( Jeong Yeong-Ha ) - Yonsei University College of Medicine Department of Neurosurgery
박상만 ( Park Sang-Man ) - Yonsei University College of Medicine Department of Neurosurgery
전형석 ( Jeon Hyeong-Seok ) - Yonsei University College of Medicine Department of Neurosurgery
김형철 ( Kim Hyung-Cheol ) - Yonsei University College of Medicine Department of Neurosurgery
 ( An Seong-Bae ) - Yonsei University College of Medicine Department of Neurosurgery
신동아 ( Shin Dong-Ah ) - Yonsei University College of Medicine Department of Neurosurgery
 ( Yi Seong ) - Yonsei University College of Medicine Department of Neurosurgery
김긍년 ( Kim Keung-Nyun ) - Yonsei University College of Medicine Department of Neurosurgery
윤도흠 ( Yoon Do-Heum ) - Yonsei University College of Medicine Department of Neurosurgery
신준재 ( Shin Jun-Jae ) - Yonsei University College of Medicine Department of Neurosurgery
하윤 ( Ha Yoon ) - Yonsei University College of Medicine Department of Neurosurgery

Abstract


Neuromuscular disorders (NMDs) are diseases involving the upper and lower motor neurons and muscles. In patients with NMDs, cervical spinal deformities are a very common issue; however, unlike thoracolumbar spinal deformities, few studies have investigated these disorders. The patients with NMDs have irregular spinal curvature caused by poor balance and poor coordination of their head, neck, and trunk. Particularly, cervical deformity occurs at younger age, and is known to show more rigid and severe curvature at high cervical levels. Muscular physiologic dynamic characteristics such as spasticity or dystonia combined with static structural factors such as curvature flexibility can result in deformity and often lead to traumatic spinal cord injury. In addition, postoperative complication rate is higher due to abnormal involuntary movement and muscle tone. Therefore, it is important to control abnormal involuntary movement perioperatively along with strong instrumentation for correction of deformity. Various methods such as botulinum toxin injection, physical therapy, muscle division technique, or intrathecal baclofen pump implant may help control abnormal involuntary movements and improve spinal stability. Surgical management for cervical deformities associated with NMDs requires a multidisciplinary effort and a customized strategy.

키워드

Neuromuscular disorders; Cervical deformity; Abnormal involuntary movement

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