Developmental medicine and child neurology · 2026
Cervical cord deformation in cerebral palsy: Structural signatures of gross motor function and outcomes after selective dorsal rhizotomy.
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Latypov Timur H, Mithani Karim, Breitbart Sara, Douglas Juliana, Gill Amber, Cotton Jackie, Takeuchi Leah, Chin-A-Young Aimee, Milo-Manson Golda, Fehlings Darcy, Ibrahim George M
Аннотация
AIM: To identify structural signatures of cerebral palsy (CP) motor impairment and selective dorsal rhizotomy (SDR) outcomes using spinal cord deformation-based morphometry (scDBM).
METHOD: This retrospective study quantifies spinal cord structural abnormalities in 39 children with CP, stratified by the baseline motor function (Gross Motor Function Classification System [GMFCS] levels I-II, n = 21 and GMFCS level > II, n = 18). T1-weighted clinical images were non-linearly registered to a healthy normative template. Localized spinal cord tissue volume change was modeled against baseline Gross Motor Function Measure (GMFM-66) and 12-month postSDR improvement.
RESULTS: In children with ambulatory impairment (GMFCS level > II, n = 18), lower motor capacity correlated with localized rostral cervical (C1-C4) deformation (p < 0.05); no correlates were identified in GMFCS levels I to II (n = 21). Clinical improvement after SDR was associated with baseline C1 dimensions closer to normative adult values, specifically involving reticulospinal and vestibulospinal tracts (p < 0.05).
INTERPRETATION: Spinal cord morphology reflects motor potential and surgical outcomes in CP (GMFCS level > II). Localizing C1 structural deficit, scDBM may provide an objective structural signature of severity to identify presurgical candidates with the necessary reserve to translate spasticity reduction into clinically meaningful motor gains.
METHOD: This retrospective study quantifies spinal cord structural abnormalities in 39 children with CP, stratified by the baseline motor function (Gross Motor Function Classification System [GMFCS] levels I-II, n = 21 and GMFCS level > II, n = 18). T1-weighted clinical images were non-linearly registered to a healthy normative template. Localized spinal cord tissue volume change was modeled against baseline Gross Motor Function Measure (GMFM-66) and 12-month postSDR improvement.
RESULTS: In children with ambulatory impairment (GMFCS level > II, n = 18), lower motor capacity correlated with localized rostral cervical (C1-C4) deformation (p < 0.05); no correlates were identified in GMFCS levels I to II (n = 21). Clinical improvement after SDR was associated with baseline C1 dimensions closer to normative adult values, specifically involving reticulospinal and vestibulospinal tracts (p < 0.05).
INTERPRETATION: Spinal cord morphology reflects motor potential and surgical outcomes in CP (GMFCS level > II). Localizing C1 structural deficit, scDBM may provide an objective structural signature of severity to identify presurgical candidates with the necessary reserve to translate spasticity reduction into clinically meaningful motor gains.