1. Copyright © 2014 Lippincott Williams & Wilkins. Unauthorized commercial reproduction of this slide is prohibited Supplemental PowerPoint Slides Morphological Characteristics of Cervical Spine in Patients with Athetoid Cerebral Palsy and the Accuracy of Pedicle Screw Placement So Kato, MD,* Naoki Shoda, MD,* Hirotaka Chikuda, MD, PhD,* Atsushi Seichi, MD,† and Katsushi Takeshita, MD, PhD* From the *Department of Orthopaedic Surgery, Sensory and Motor System Medicine, Surgical Sciences, Graduate School of Medicine, the University of Tokyo, Tokyo, Japan; and †Department of Orthopaedics, Jichi Medical University, Shimotsuke, Japan.

2. Key Points Pedicle diameter in cerebral palsy (CP) was larger than in cervical spondylotic myelopathy (CSM) Pedicle sclerosis is more frequently observed in CP than in CSM High risk of pedicle screw misplacement is associated with pedicle sclerosis

3. Case presentation Revision surgery for CP Pedicle sclerosis Wide transverse angle Lateral mass deformity Consider alternative fixation techniques (i.e., lateral mass screws) in high risk cases!