Cervical arthroplasty in a patient with Klippel-Feil syndrome Authors
First Online: 09 July 2007 Received: 01 October 2006 Accepted: 15 January 2007 DOI:
Cite this article as: Yi, S., Kim, S., Shin, H. et al. Acta Neurochir (Wien) (2007) 149: 805. doi:10.1007/s00701-007-1115-7 Summary
This is the first published report of a patient with Klippel-Feil syndrome treated with cervical arthroplasty. A 36-year-old man presented with posterior neck pain and myelopathic symptoms. A radiograph demonstrated congenital fusion of the vertebral bodies at C2–3, C4–5 and C5–6. On MRI, the spinal cord was compressed by a protruding cervical disc and bony spurs at C6–7. After anterior discectomy and decompression of the spinal cord at the C6–7 level, the disc was replaced with the Bryan cervical disc system (Medtronic Sofamor Danek, Memphis, TN, USA) to restore normal motion. The absence of adjacent segment degeneration and the preservation of cervical motion were noted 2 years after surgery. Arthroplasty may be performed in selected patients with Klippel-Feil syndrome in order to restore motion and to prevent degeneration of the adjacent segment by reducing hypermobility.
Keywords: Arthroplasty; Bryan disc; cervical spine; Klippel-Feil syndrome; hypermobility. References Baba, H, Maezawa, Y, Furusawa, N, Chen, Q, Imura, S, Tomita, K 1995 The cervical spine in the Klippel-Feil syndrome. A report of 57 cases Int Orthop 19 204 208 PubMed CrossRef Elster, AD 1984 Quadriplegia after minor trauma in the Klippel-Feil syndrome. A case report and review of the literature J Bone Joint Surg Am 66 1473 1474 PubMed Hensinger, RN, Lang, JE, MacEwen, GD 1974 Klippel-Feil syndrome; a constellation of associated anomalies J Bone Joint Surg Am 56 1246 1253 PubMed Jeanneret, B, Magerl, F 1990 Congenital fusion C1-C2 associated with spondylolysis of C2 J Spinal Disord 3 413 417 PubMed Karasick, D, Schweitzer, ME, Vaccaro, AR 1998 The traumatized cervical spine in Klippel-Feil syndrome: imaging features AJR Am J Roentgenol 170 85 88 PubMed Nagashima, H, Morio, Y, Teshima, R 2001 No neurological involvement for more than 40 years in Klippel-Feil syndrome with severe hypermobility of the upper cervical spine Arch Orthop Trauma Surg 121 99 101 PubMed CrossRef Nagib, MG, Maxwell, RE, Chou, SN 1985 Klippel-Feil syndrome in children: clinical features and management Childs Nerv Syst 1 255 263 PubMed CrossRef Pickett, GE, Mitsis, DK, Sekhon, LH, Sears, WR, Duggal, N 2004 Effects of a cervical disc prosthesis on segmental and cervical spine alignment Neurosurg Focus 17 E5 PubMed Pizzutillo, PD, Woods, M, Nicholson, L, MacEwen, GD 1994 Risk factors in Klippel-Feil syndrome Spine 19 2110 2116 PubMed CrossRef Schaffer, AA, Kaplan, FS, Tracy, MR, O’Brien, ML, Dormans, JP, Shore, EM, Harland, RM, Kusumi, K 2005 Developmental anomalies of the cervical spine in patients with fibrodysplasia ossificans progressiva are distinctly different from those in patients with Klippel-Feil syndrome: clues from the BMP signalling pathway Spine 30 1379 1385 PubMed CrossRef Sekhon, LH, Sears, W, Duggal, N 2005 Cervical arthroplasty after previous surgery: results of treating 24 discs in 15 patients J Neurosurg Spine 3 335 341 PubMed CrossRef Southwell, RB, Reynolds, AF, Badger, VM, Sherman, FC 1980 Klippel-Feil syndrome with cervical compression resulting from cervical subluxation in association with an omo-vertebral bone Spine 5 480 482 PubMed CrossRef Vaidyanathan, S, Hughes, PL, Soni, BM, Singh, G, Sett, P 2002 Klippel-Feil syndrome – the risk of cervical spinal cord injury: a case report BMC Fam Pract 3 6 PubMed CrossRef