Traumatic Myelopafhy in a Seventeen-Year-Old Child with Cervical Spinal Stenosis (Without Fracture or Dislocation) and a C2-C3 Klippel-Feil Fusion

Epstein, Nancy E.; Epstein, Joseph A.; Zilkha, Albert

doi:10.1097/00007632-198405000-00003

Cited by 18 publications

(9 citation statements)

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“…Cervical corpectomy or laminectomy may be required for adequate decompression with extension of disease posteriorly. Discussion of specific surgical techniques for management of symptomatic KFS patients has primarily been limited to case reports [14,32,[34][35][36][37][38]. In this particular case, an anterior cervical discectomy and fusion (ACDF) was chosen for treatment of single-level disease, as imaging demonstrated anterolisthesis and narrowing of the spinal canal at the level of the C3-C4 with a bulging disc.…”

Section: Discussionmentioning

confidence: 99%

Cervical instability in Klippel-Feil syndrome: case report and review of the literature

et al. 2015

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Background: The authors present a case of cervical myelopathy and radiculopathy in the setting of multiple Klippel-Feil syndrome abnormalities treated surgically with a single-level C3-C4 anterior cervical discectomy and fusion. We discuss the clinical presentation, radiographic findings, and various treatment options for cervical spine abnormalities in Klippel-Feil syndrome. Case Presentation: This 22-year-old female with Klippel-Feil syndrome presented with intermittent neck pain, left upper extremity weakness, and paresthesias. Preoperative MRI, CT, and X-rays of the cervical spine revealed anterolisthesis at C3/4 with unstable movement on flexion and extension imaging. In addition, there were multiple segmental fusion abnormalities including hemivertebrae and other congenital fusion abnormalities. A C3-C4 anterior cervical discectomy and fusion was performed with intervertebral disc spacer. Adequate decompression was achieved with postoperative resolution of the patient's symptoms and improvement in neurological exam. Conclusions: Single-level anterior cervical discectomy and fusion can be utilized for treatment of cervical myelopathy and radiculopathy in the setting of multiple congenital Klippel-Feil syndrome abnormalities.

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Section: Discussionmentioning

confidence: 99%

Cervical instability in Klippel-Feil syndrome: case report and review of the literature

et al. 2015

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“…a Lateral radiograph of a patient with C4-C7 fusion, b MRI suggesting entrapment of the right L5 root (arrow) Fig. 5 a, b. A man, 27 years of age, with C2-C3 fusion and thoracolumbar scoliosis, a Radiograph shows a typical waspwaist appearance, b After thoraco-lumbar Zielke VDS operation most minor cervical injury [5,6,13,16,25,30,31]. Warner described a low incidence of paresis [29], but we found an unexpectedly high occurrence of secondary structural compromise.…”

Section: Discussionmentioning

confidence: 99%

The cervical spine in the Klippel-Feil syndrome

Baba

Maezawa

Furusawa

et al. 1995

International Orthopaedics

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We report 57 cases of the Klippel-Feil syndrome. Five had type I congenital cervical fusion, 48 type II and 4 type III. The symptoms and signs varied considerably. Patients with C2-C3 fusion often had symptoms associated with odontoid dysplasia and occipito-cervical instability. Twenty-one had progressive neurological symptoms and 19 were operated on: 3 had occiput-C3 posterior arthrodeses, 2 a single level fusion, 1 a laminectomy and anterior arthrodesis, and 13 had laminoplasties. Degenerative changes at the unfused segment and a narrow bony canal are high risk factors in the development of neurological compromise.

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“…In a review of 212 patients operated on for spinal cord masses, nine were found to be non-neoplastic intramedullary lesions, of which only one was an inflammatory mass. 17 Interestingly, they concluded that lack of spinal cord expansion associated with an intramedullary mass is the hallmark of a non-neoplastic lesion. 17 A recent review of 38 patients who underwent spinal cord biopsy for intramedullary lesions found that only 87% of neoplastic cases demonstrated cord expansion.…”

Section: Discussionmentioning

confidence: 99%

“…17 Interestingly, they concluded that lack of spinal cord expansion associated with an intramedullary mass is the hallmark of a non-neoplastic lesion. 17 A recent review of 38 patients who underwent spinal cord biopsy for intramedullary lesions found that only 87% of neoplastic cases demonstrated cord expansion. 18 In addition, thay also found that 94% of patients with inflammatory lesions demonstrated spinal cord expansion.…”

Section: Discussionmentioning

confidence: 99%

Intramedullary inflammatory mass dorsal to the Klippel–Feil deformity: error in development or response to an abnormal motion segment?

2004

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Study design: Case study on a 45-year-old female with progressive weakness and paresthesias in her lower extremities and a magnetic resonance image of an intramedullary mass at the level of C5-6 and a Klippel-Feil (KF) deformity ventral to the lesion. Objective: Present an interesting case of an intramedullary mass coexisting with a ventral KF deformity with review of the medical literature on intramedullary masses and cervical spine biomechanics. Setting: New York city, New York, USA. Methods: Case study with discussion of neurosurgical and neuropathological findings and review of the literature. Results:The patient underwent open neurosurgical excisional biopsy of the intramedullary mass which revealed a non-neoplastic inflammatory mass that slowly resolved with medical management. Conclusions: While no definitive etiology was found in this case we offer two interesting mechanisms: (1) maldevelopment of the cervical spine or (2) this inflammatory mass is in response to an abnormal motion at the level of the Klippel-Feil.

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Traumatic Myelopafhy in a Seventeen-Year-Old Child with Cervical Spinal Stenosis (Without Fracture or Dislocation) and a C2-C3 Klippel-Feil Fusion

Cited by 18 publications

References 0 publications

Cervical instability in Klippel-Feil syndrome: case report and review of the literature

Cervical instability in Klippel-Feil syndrome: case report and review of the literature

The cervical spine in the Klippel-Feil syndrome

Intramedullary inflammatory mass dorsal to the Klippel–Feil deformity: error in development or response to an abnormal motion segment?

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