Cervical Spine Cord Injury Associated with Klippel-Feil Syndrome: A Case Report

Roger Mulumba Ilunga,Vital Nacoulma,Abdoulaye Diop,Mohameth Faye,Nicaise Akodjetin Mahougnon Sodjinou

doi:10.4236/ojo.2021.114013

Abstract

Background: Klippel Feil syndrome (KFS) is a congenital malformation characterised by the presence of, at least, one fused cervical segment and results from faulty segmentation along the embryo’s developing axis during weeks 3 - 8 of gestation. The KFS increases the risk for spinal cord injury after minor trauma as a result of the disturbance of the biomechanics of the cervical spine. Persons with KFS often have associated congenital anomalies. Aim: The purpose of this study was to show the surgical management difficulties of this pathology in a low income country such as Senegal and to make a review of the literature. Case presentation: A 32-year-old man developed a tetraparesis secondary to a fall from his height while carrying a bag of rice on his head. Radiological explorations revealed fusedC2-C3 and C4-C5 vertebral bodies with a C3-C4 disc herniation associated to a spine contusion. The patient underwent surgical removal of the herniated disc via an anterior approach followed by interbody fusion and anterior plating. A complete recovery was noted at 4 months follow-up. Conclusion: Understanding of the cervical spine biomechanics of Klippel-Feil anomaly may allow an optimal management of patients. Patients with KFS should be warned of the increased risk of spinal cord injury after a low velocity trauma. Timing for surgery should be shortened.

Highlights

Klippel Feil syndrome (KFS) is a congenital malformation characterised by the presence of, at least, one fused cervical segment and results from faulty segmentation along the embryo’s developing axis during weeks 3 - 8 of gestation
The KFS increases the risk for spinal cord injury after minor trauma as a result of the disturbance of the biomechanics of the cervical spine
Understanding of the cervical spine biomechanics of Klippel-Feil anomaly may allow an optimal management of patients

Summary

Introduction

Klippel Feil syndrome (KFS) is a congenital malformation characterised by the presence of, at least, one fused cervical segment and results from faulty segmentation along the embryo’s developing axis during weeks 3 - 8 of gestation. Conclusion: Understanding of the cervical spine biomechanics of Klippel-Feil anomaly may allow an optimal management of patients. The major feature of KFS is congenital fusion of two or more cervical vertebrae This causes a biomechanical disturbance that increases the risk of developing neurological damage even in the event of minimal trauma to the cervical spine [10] [11]. We present a case of a post-traumatic tetraparesis in a 32-years-old patient with KFS treated surgically with an anterior cervical discectomy and fusion. The difficulties encountered during the management of this case are discussed

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