Case Report
Volume 3 Issue 6 - 2020
Clinical Evaluation of Surgical Treatment for the Upper Cervical Instability Associated with Klippel-Feil Syndrome
Guoqi Niu*, Pengpeng Li, Jianhao Dai, Gong Zhou, Dong Bengbu Medical Co Wang, Lutan Liu, Qiankun Zhou, Hui Chen, Tao Liu and Hu Nie
The Second Affiliated Hospital of Bengbu Medical College, Bengbu, China
*Corresponding Author: Guoqi Niu, The Second Affiliated Hospital of Bengbu Medical College, Bengbu, China.
Received: February 27, 2020; Published: May 29, 2020




Abstract

Purpose: To evaluate the clinical efficacy of preoperative and postoperative treatment of patients with Klippel-Feil syndrome (KFS).

Methods: 8 patients with KFS with cervical instability were selected as the subjects during April 2008 to June 2015, including 3 males and 5 females, who aged 25 - 45 years. These 8 patients were accompanied by cervical spine instability of C2-3 congenital fusion, surgical treatment, postoperative rehabilitation training and health education, regular review of imaging tests, physical examination, as well as assessment by Japanese Orthopaedic Association (JOA) and American Spinal Injury Association (ASIA) scoring systems.

Results: The 8 patients were successfully followed up for surgery. Statistical analysis results of all patients with lateral cervical spine, no internal fixation failure, were well graft fusion, in which 8 patients were no incontinence, no obvious spinal cord, nerve root, and vertebral artery injury. However, only 1 patient after 5 months showed recurrence of atlantoaxial dislocation, which led to the second hospitalization. The final postoperative score of JOA was significantly increased compared with the preoperative score, as well as the ASIA ensory score and exercise score. In one patient, a three dimensional (3D) printing guide plate was used to assist pedicle screw placement, which was accurate and safe.

Conclusion: Surgical treatment of KFS patients with cervical spine instability is still risky, however, surgical treatment can alleviate or cure the postoperative symptoms. Here, 8 patients were satisfied with the results of surgical treatment, therefore, the surgical treatment with cervical instability in patients with KFS is a highly effective treatment strategy.

Keywords: KFS; Upper Cervical Spine; Surgical Treatment; 3D Printing Guide Plate; Japanese Orthopaedic Association (JOA) Score

References

  1. Juberg RC and Gershanik JJ. “Cervical vertebral fusion (Klippel-Feil) syndrome with consanguineous parents”. Journal of Medical Genetics3 (1976): 246-249.
  2. Tawk RG., et al. “Hypersegmentation, Klippel-Feil syndrome, and hemivertebra in a scoliotic patient”. Journal of the American College of Surgeons4 (2002): 570-571.
  3. Samartzis D., et al. “Symptomatic cervical disc herniation in a pediatric Klippel-Feil patient: the risk of neural injury associated with extensive congenitally fused vertebrae and a hypermobile segment”. Spine 11 (2006): E335-338.
  4. Liu Y and Li M. “Research progress in klippel-feil syndrome”. Journal of Spinal Surgery 1 (2005): 46.
  5. Pizzutillo PD., et al. “Risk factors in Klippel-Feil syndrome”. Spine18 (1994): 2110-2116.
  6. Khilji MF. “Klippel-Feil syndrome”. Chinese Journal of Contemporary Neurology and Neurosurgery12 (2013): 1050.
  7. Samartzis D., et al. “Superior odontoid migration in the Klippel-Feil patient”. European Spine Journal9 (2007): 1489-1497.
  8. Wang S., et al. “Pedicle versus laminar screws: what provides more suitable C2 fixation in congenital C2-3 fusion patients?” European Spine Journal8 (2010): 1306-1311.
  9. Samartzis D., et al. “Atlantoaxial rotatory fixation in the setting of associated congenital malformations: a modified classification system”. Spine 4 (2010): E119-127.
  10. Yurube T., et al. “The vanishment of an intramedullary high-signal intensity lesion at the craniocervical junction after surgical treatment: a case report of the presyrinx state”. Spine6 (2009): E235-E239.
  11. Dokai T., et al. “Posterior occipitocervical fixation under skull-femoral traction for the treatment of basilar impression in a child with Klippel-Feil syndrome”. The Journal of Bone and Joint Surgery British Volume11 (2011): 1571-1574.
  12. Bettegowda C., et al. “Sublabial approach for the treatment of symptomatic basilar impression in a patient with Klippel-Feil syndrome”. Neurosurgery1 (2011): ons77-82.
  13. Yin Qs., et al. “Treatment of refractory atlantoaxial dislocation by transoropharyngeal atlantoaxial reduction plate”. Journal of Spinal Surgery1 (2004): 6.
  14. Zhuang Qs., et al. “Treatment of refractory atlantoaxial dislocation with posterior pedicle screw fixation by anterior oropharyngeal release”. Chinese Journal of Spine and Spinal Cord6 (2009): 430.
  15. King NK., et al. “A computed tomography morphometric study of occipital bone and C2 pedicle anatomy for occipital-cervical fusion”. Surgical Neurology International7 (2014): S380-S383.
  16. Winegar CD., et al. “A systematic review of occipital cervical fusion: techniques and outcomes”. Journal of Neurosurgery Spine1 (2010): 5-16.
  17. Wei G., et al. “Treatment of Basilar Invagination With Klippel-Feil Syndrome: Atlantoaxial Joint Distraction and Fixation With Transoral Atlantoaxial Reduction Plate”. Neurosurgery 4 (2016): 492-498.
Citation: Guoqi Niu., et al. “Clinical Evaluation of Surgical Treatment for the Upper Cervical Instability Associated with Klippel-Feil Syndrome”. EC Clinical and Experimental Anatomy 3.6 (2020): 33-40.

PubMed Indexed Article


EC Pharmacology and Toxicology
LC-UV-MS and MS/MS Characterize Glutathione Reactivity with Different Isomers (2,2' and 2,4' vs. 4,4') of Methylene Diphenyl-Diisocyanate.

PMID: 31143884 [PubMed]

PMCID: PMC6536005


EC Pharmacology and Toxicology
Alzheimer's Pathogenesis, Metal-Mediated Redox Stress, and Potential Nanotheranostics.

PMID: 31565701 [PubMed]

PMCID: PMC6764777


EC Neurology
Differences in Rate of Cognitive Decline and Caregiver Burden between Alzheimer's Disease and Vascular Dementia: a Retrospective Study.

PMID: 27747317 [PubMed]

PMCID: PMC5065347


EC Pharmacology and Toxicology
Will Blockchain Technology Transform Healthcare and Biomedical Sciences?

PMID: 31460519 [PubMed]

PMCID: PMC6711478


EC Pharmacology and Toxicology
Is it a Prime Time for AI-powered Virtual Drug Screening?

PMID: 30215059 [PubMed]

PMCID: PMC6133253


EC Psychology and Psychiatry
Analysis of Evidence for the Combination of Pro-dopamine Regulator (KB220PAM) and Naltrexone to Prevent Opioid Use Disorder Relapse.

PMID: 30417173 [PubMed]

PMCID: PMC6226033


EC Anaesthesia
Arrest Under Anesthesia - What was the Culprit? A Case Report.

PMID: 30264037 [PubMed]

PMCID: PMC6155992


EC Orthopaedics
Distraction Implantation. A New Technique in Total Joint Arthroplasty and Direct Skeletal Attachment.

PMID: 30198026 [PubMed]

PMCID: PMC6124505


EC Pulmonology and Respiratory Medicine
Prevalence and factors associated with self-reported chronic obstructive pulmonary disease among adults aged 40-79: the National Health and Nutrition Examination Survey (NHANES) 2007-2012.

PMID: 30294723 [PubMed]

PMCID: PMC6169793


EC Dental Science
Important Dental Fiber-Reinforced Composite Molding Compound Breakthroughs

PMID: 29285526 [PubMed]

PMCID: PMC5743211


EC Microbiology
Prevalence of Intestinal Parasites Among HIV Infected and HIV Uninfected Patients Treated at the 1o De Maio Health Centre in Maputo, Mozambique

PMID: 29911204 [PubMed]

PMCID: PMC5999047


EC Microbiology
Macrophages and the Viral Dissemination Super Highway

PMID: 26949751 [PubMed]

PMCID: PMC4774560


EC Microbiology
The Microbiome, Antibiotics, and Health of the Pediatric Population.

PMID: 27390782 [PubMed]

PMCID: PMC4933318


EC Microbiology
Reactive Oxygen Species in HIV Infection

PMID: 28580453 [PubMed]

PMCID: PMC5450819


EC Microbiology
A Review of the CD4 T Cell Contribution to Lung Infection, Inflammation and Repair with a Focus on Wheeze and Asthma in the Pediatric Population

PMID: 26280024 [PubMed]

PMCID: PMC4533840


EC Neurology
Identifying Key Symptoms Differentiating Myalgic Encephalomyelitis and Chronic Fatigue Syndrome from Multiple Sclerosis

PMID: 28066845 [PubMed]

PMCID: PMC5214344


EC Pharmacology and Toxicology
Paradigm Shift is the Normal State of Pharmacology

PMID: 28936490 [PubMed]

PMCID: PMC5604476


EC Neurology
Examining those Meeting IOM Criteria Versus IOM Plus Fibromyalgia

PMID: 28713879 [PubMed]

PMCID: PMC5510658


EC Neurology
Unilateral Frontosphenoid Craniosynostosis: Case Report and a Review of the Literature

PMID: 28133641 [PubMed]

PMCID: PMC5267489


EC Ophthalmology
OCT-Angiography for Non-Invasive Monitoring of Neuronal and Vascular Structure in Mouse Retina: Implication for Characterization of Retinal Neurovascular Coupling

PMID: 29333536 [PubMed]

PMCID: PMC5766278


EC Neurology
Longer Duration of Downslope Treadmill Walking Induces Depression of H-Reflexes Measured during Standing and Walking.

PMID: 31032493 [PubMed]

PMCID: PMC6483108


EC Microbiology
Onchocerciasis in Mozambique: An Unknown Condition for Health Professionals.

PMID: 30957099 [PubMed]

PMCID: PMC6448571


EC Nutrition
Food Insecurity among Households with and without Podoconiosis in East and West Gojjam, Ethiopia.

PMID: 30101228 [PubMed]

PMCID: PMC6086333


EC Ophthalmology
REVIEW. +2 to +3 D. Reading Glasses to Prevent Myopia.

PMID: 31080964 [PubMed]

PMCID: PMC6508883


EC Gynaecology
Biomechanical Mapping of the Female Pelvic Floor: Uterine Prolapse Versus Normal Conditions.

PMID: 31093608 [PubMed]

PMCID: PMC6513001


EC Dental Science
Fiber-Reinforced Composites: A Breakthrough in Practical Clinical Applications with Advanced Wear Resistance for Dental Materials.

PMID: 31552397 [PubMed]

PMCID: PMC6758937


EC Microbiology
Neurocysticercosis in Child Bearing Women: An Overlooked Condition in Mozambique and a Potentially Missed Diagnosis in Women Presenting with Eclampsia.

PMID: 31681909 [PubMed]

PMCID: PMC6824723


EC Microbiology
Molecular Detection of Leptospira spp. in Rodents Trapped in the Mozambique Island City, Nampula Province, Mozambique.

PMID: 31681910 [PubMed]

PMCID: PMC6824726


EC Neurology
Endoplasmic Reticulum-Mitochondrial Cross-Talk in Neurodegenerative and Eye Diseases.

PMID: 31528859 [PubMed]

PMCID: PMC6746603


EC Psychology and Psychiatry
Can Chronic Consumption of Caffeine by Increasing D2/D3 Receptors Offer Benefit to Carriers of the DRD2 A1 Allele in Cocaine Abuse?

PMID: 31276119 [PubMed]

PMCID: PMC6604646


EC Anaesthesia
Real Time Locating Systems and sustainability of Perioperative Efficiency of Anesthesiologists.

PMID: 31406965 [PubMed]

PMCID: PMC6690616


EC Pharmacology and Toxicology
A Pilot STEM Curriculum Designed to Teach High School Students Concepts in Biochemical Engineering and Pharmacology.

PMID: 31517314 [PubMed]

PMCID: PMC6741290


EC Pharmacology and Toxicology
Toxic Mechanisms Underlying Motor Activity Changes Induced by a Mixture of Lead, Arsenic and Manganese.

PMID: 31633124 [PubMed]

PMCID: PMC6800226


EC Neurology
Research Volunteers' Attitudes Toward Chronic Fatigue Syndrome and Myalgic Encephalomyelitis.

PMID: 29662969 [PubMed]

PMCID: PMC5898812


EC Pharmacology and Toxicology
Hyperbaric Oxygen Therapy for Alzheimer's Disease.

PMID: 30215058 [PubMed]

PMCID: PMC6133268


News and Events


October Issue Release

We always feel pleasure to share our updates with you all. Here, notifying you that we have successfully released the October issue of respective journals and can be viewed in the current issue pages.

Submission Deadline for November Issue

Ecronicon delightfully welcomes all the authors around the globe for effective collaboration with an article submission for the November issue of respective journals. Submissions are accepted on/before October 31, 2020.

Certificate of Publication

Ecronicon honors with a "Publication Certificate" to the corresponding author by including the names of co-authors as a token of appreciation for publishing the work with our respective journals.

Best Article of the Issue

Editors of respective journals will always be very much interested in electing one Best Article after each issue release. The authors of the selected article will be honored with a "Best Article of the Issue" certificate.

Certifying for Review

Ecronicon certifies the Editors for their first review done towards the assigned article of the respective journals.

Latest Articles

The latest articles will be updated immediately on the articles in press page of the respective journals.

Immediate Assistance

The prime motto of this team is to clarify all the queries without any delay or hesitation to avoid the inconvenience. For immediate assistance on your queries please don't hesitate to drop an email to editor@ecronicon.uk