Posterior occipitocervical fixation under skull-femoral traction for the treatment of basilar impression in a child with Klippel–Feil syndrome

Dokai, Toshiyuki; Nagashima, Hideki; Nanjo, Yoshiro; Tanida, Atsushi; Teshima, Ryota

doi:10.1302/0301-620x.93b11.26892

Cited by 9 publications

(4 citation statements)

References 27 publications

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“…Therefore, early identification of KFS is paramount to minimize the risk of neurologic injury during daily activities or operative management of such patients [22]. Interestingly, in a cohort of 32 patients with concomitant scoliosis and KFS, only 2 required surgical intervention [23]. The role of prophylactic surgical stabilization in people with isolated neck pain or without symptoms remains controversial [24].…”

Section: Discussionmentioning

confidence: 99%

Cervical vertebral malformations in 9 dogs: radiological findings, treatment options and outcomes

et al. 2019

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Background Disregarding atlantoaxial instability in toy breed dogs associated with dens malformation and cervical spondylomyelopathy; cervical vertebral malformations are rare and poorly characterised in veterinary medicine and consequently treatment strategies and clinical outcome are sparsely documented. Results Electronic clinical records at our veterinary referral hospital between April 2009 and November 2018 were searched for patients presented with cervical myelopathy secondary to an underlying suspected vertebral malformation/instability. Nine dogs met the inclusion criteria. Two dogs were diagnosed with atlantoaxial pseudoarthrosis, two dogs with a syndrome similar to Klippel-Feil in humans, two dogs with congenital cervical fusion, two dogs with congenital C2-C3 canal stenosis and deficiencies of the dorsal arch of the atlas and laminae of the axis and one with axial rotatory displacement. Tetraparesis, proprioceptive deficits, cervical hyperesthesia and cervical scoliosis were the most common clinical signs. The axis was the most commonly affected vertebrae (8/9 patients). Patients diagnosed with Klippel-Feil-like Syndrome were the younger (average of 262.5 days) and patients diagnosed with fused vertebrae the oldest (average of 2896 days) in our studied population (average of 1580.8 days). Conclusion Cervical vertebral malformations are rare, or alternatively, being underdiagnosed in veterinary medicine. Patients diagnosed with Klippel-Feil-like Syndrome had a successful medium and long-term outcome with conservative management. Surgical treatment was often indicated for the other conditions presented in this study due to spinal instability and/or myelopathy. Stabilisations via ventral approaches were revealed to be safe. Multicentre and prospective studies are necessary in veterinary medicine to better characterise clinical outcomes in cervical vertebral malformations.

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Section: Discussionmentioning

confidence: 99%

Cervical vertebral malformations in 9 dogs: radiological findings, treatment options and outcomes

et al. 2019

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“…VA anomalies often appear in patients to be congenital or acquired disorders. Complex anomalies of the lower cervical vertebrae caused by vertebral fusion disorder are collectively termed Klippel–Feil syndrome 10 …”

Section: Discussionmentioning

confidence: 99%

“…Complex anomalies of the lower cervical vertebrae caused by vertebral fusion disorder are collectively termed Klippel-Feil syndrome. 10 The development of blood vessels and vertebrae in the cervical region is similar in humans and other chordates-the development of vertebrae is closely associated with the gradual development and regression of both the sclerotomes, the pharyngeal arches and their primitive vessels. 3,7 Nevertheless, veterinary research papers only rarely monitor the anatomical variations.…”

Section: Discussionmentioning

confidence: 99%

Anomaly of the sixth cervical vertebra accompanied by atypical course of the vertebral artery in a dog

Korim

Kuricová

Lipták

et al. 2022

Vet Record Case Reports

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The vertebral arteries, as the first branches from the subclavian arteries, normally enter into the transverse foramen of the sixth cervical vertebra in dogs. This case report presents the non‐standard course of the left vertebral artery and unilateral asymmetry of the sixth cervical vertebra in a 14‐year‐old female mixed breed dog. The anomaly was an incidental finding during the preparation of a corrosion cast prepared for educational and scientific purposes. The left sixth cervical vertebra transverse foramen and the ventral lamina were not developed. The left vertebral artery originated normally from the left subclavian artery, but atypically entered into the transverse foramen of the fifth cervical vertebra. On the right side, the anatomical structures of the sixth cervical vertebra and the course of the right vertebral artery were normally developed. To our knowledge, this is the first case of such an anomaly described in a dog.

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“…The surgical treatment of patients with KFS presenting with radiculopathy or myelopathy manifestations, deformity, or definite instability is necessary ( 14 , 15 ). In this context, anterior surgical treatment includes anterior cervical discectomy and fusion and anterior cervical corpectomy and fusion ( 17 ), while posterior surgery mainly consists of decompression and fusion surgical treatment ( 18 ). Emergency fusion surgery should be considered when the patients present with an unstable cervical spine, such as with the presence of foramen magnum occipitalis stenosis, basal ganglia depression, or any radiological evidence of progressive cervical instability.…”

Section: Discussionmentioning

confidence: 99%

Prevalence and Risk Factors of Surgical Treatment for Klippel–Feil Syndrome

et al. 2022

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BackgroundRecently, there have been some reports on surgical treatment for Klippel–Feil syndrome, but the prevalence and risk factors of surgery have not been well evaluated. This study sought to find the prevalence and potential risk factors of surgical treatment.MethodsA retrospective radiographic review of 718 Klippel–Feil syndrome patients seen at Peking University Third Hospital from January 2010 to October 2017 was performed. Parameters included age, gender, deformity, cervical instability, Samartzis classification, and surgical treatment. Based on the surgical treatment they received, patients were divided into a surgery group and a non-surgery group. Prevalence and possible risk factors of surgical treatment were assessed.ResultsA total of 718 Klippel–Feil syndrome patients, including 327 men and 391 women, with an average age of 46.8 years were enrolled. According to the Samartzis classification scheme, 621 cases (86.5%) were classified as type I, 48 cases (6.7%) were classified as type II, and 49 cases (6.8%) were classified as type III, respectively. The most commonly fused segments were C2–3 (54.9%) and C5–6 (9.3%). Of all 718 patients, 133 (18.5%) patients underwent surgical treatment, mainly via the posterior approach (69.9%). The clinical factors included age, gender, deformity, instability, and Samartzis classification. Men were more likely to require surgical treatment (p < 0.001). Patients with instability (p < 0.001) or patients with deformity (p = 0.004) were also more likely to undergo surgery. All three of these variables were included in the binary regression analysis. Finally, gender (p < 0.001) and unstable joints (p < 0.001) were identified to be independently associated with surgical treatment. Gender was the most important risk factor with men being 2.39 times more likely to have surgical treatment, while patients with instability were 2.31 times more likely to receive surgery.ConclusionThe prevalence of patients with Klippel–Feil syndrome requiring surgery was 18.5%, with the majority undergoing posterior cervical surgery. Gender and instability were indemnified as independent risk factors leading to surgical treatment.

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Posterior occipitocervical fixation under skull-femoral traction for the treatment of basilar impression in a child with Klippel–Feil syndrome

Cited by 9 publications

References 27 publications

Cervical vertebral malformations in 9 dogs: radiological findings, treatment options and outcomes

Cervical vertebral malformations in 9 dogs: radiological findings, treatment options and outcomes

Anomaly of the sixth cervical vertebra accompanied by atypical course of the vertebral artery in a dog

Prevalence and Risk Factors of Surgical Treatment for Klippel–Feil Syndrome

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