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- Title
A clinical scoring system for neurological assessment of high cervical myelopathy. Measurements in pediatric patients with congenital atlantoaxial dislocations.
- Authors
Rajkumar; Kalra, Samir Kumar; Mahapatra, Ashok Kumar
- Abstract
OBJECTIVE: The assessment of response to treatment in pediatric patients with congenital atlantoaxial dislocation (AAD) is done using disability grading system but may be better done by a score based on clinical parameters. This study proposes a scoring system based on a comprehensive neurological examination to assess surgical outcome in these patients. MATERIALS AND METHODS: 67 patients of congenital AAD less than or equal to 14 years were included analyzed prospectively. A scoring system (K&K Score) was designed at the start based on six factors namely- motor power, gait, sensory involvement, sphincteric involvement, spasticity and respiratory difficulty and all patients were assessed using this score as well as the DiLorenzo's grade (DLG) preoperatively, postoperatively and at each follow up visit. RESULT: There was very high incidence of occipitalised arch of atlas and fusion of the second and third cervical vertebrae in the irreducible variety. Most patients were in poor grades preoperatively, however the changes in score were seen more often when using the K&K Score in comparison to DLG and it corroborated better with the clinical improvement as well. CONCLUSION: The clinical profiles of pediatric patients with AAD are similar with a higher incidence of atlas arch anomalies in patients with irreducible AAD. A scoring system based on clinical parameters is proposed for clinical evaluation of such patients and it is easy to use and interpret and is more sensitive to the changes in neurological status of patients.
- Subjects
HEALTH outcome assessment; CERVICAL vertebrae dislocation; DISLOCATIONS in children; HUMAN abnormalities; PEDIATRIC neurology
- Publication
Journal of Pediatric Neurosciences, 2007, Vol 2, Issue 2, p103
- ISSN
1817-1745
- Publication type
Article