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Klippel-Feil syndrome in congenital scoliosis.
Spine (Phila Pa 1976). 2014 Nov 01; 39(23):E1353-8.S

Abstract

STUDY DESIGN

Retrospective review.

OBJECTIVE

To investigate the clinical manifestations and radiological characteristics of Klippel-Feil syndrome (KFS) in congenital scoliosis (CS). To identify the incidence of spinal or extraspinal abnormities in KFS.

SUMMARY OF BACKGROUND DATA

KFS is an uncommon condition, characterized as improper segmentation of one or more cervical spine segments. "Scoliosis" is potentially the most common manifestation associated with KFS. However, the clinical manifestations and radiological characteristics of KFS in patients with CS are less reported.

METHODS

A total of 516 patients with CS from January 2009 to March 2013 were identified from a single institution. The demographic distribution and clinical and radiographical data were collected. Cervical regions were also designated as high (O-C2), mid (C2-C4), and low (C4-T1). The incidence of intra- and extraspinal abnormalities associated with KFS was investigated.

RESULTS

In total, 28 patients (5.42%) had been identified with KFS, which included 8 males and 20 females. The mean coronal cervical alignment was 20.6° and sagittal alignment was 29.9°. KFS type I was found in 14 patients (50.0%), type II in 6 (21.4%), and type III in 8 (28.6%). Congenitally fused cervical segment is more common in the mid and lower cervical spine region (85.7%, 24/28). In the 28 patients with KFS, 11 have intraspinal anomalies (32.1%) and 6 have extraskeletal anomalies (21.4%). Thirteen patients (46.4%) exhibited rib anomalies. The incidence of rib anomalies showed no significant difference in CS patients with KFS and without KFS (P>0.05). A half of the patients with KFS have hemivertebrae; however, the incidence of hemivertebrae showed no significant difference in CS patients with KFS and without KFS (P>0.05).

CONCLUSION

The incidence of KFS was 5.42% in patients with CS. Congenitally fused cervical patterns are more common in the mid and lower cervical spine region. The incidence of rib anomalies, intraspinal abnormities, and hemivertebra was not increased in CS patients with KFS.

LEVEL OF EVIDENCE

4.

Authors+Show Affiliations

From the Department of Orthopedics, Peking Union Medical College Hospital, Chinese Academy of Medical Science, Peking Union Medical College, Beijing, China.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

25202932

Citation

Xue, Xuhong, et al. "Klippel-Feil Syndrome in Congenital Scoliosis." Spine, vol. 39, no. 23, 2014, pp. E1353-8.
Xue X, Shen J, Zhang J, et al. Klippel-Feil syndrome in congenital scoliosis. Spine. 2014;39(23):E1353-8.
Xue, X., Shen, J., Zhang, J., Tian, Y., Zhao, H., Wang, Y., Liang, J., Li, Z., & Qiu, G. (2014). Klippel-Feil syndrome in congenital scoliosis. Spine, 39(23), E1353-8. https://doi.org/10.1097/BRS.0000000000000587
Xue X, et al. Klippel-Feil Syndrome in Congenital Scoliosis. Spine. 2014 Nov 1;39(23):E1353-8. PubMed PMID: 25202932.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Klippel-Feil syndrome in congenital scoliosis. AU - Xue,Xuhong, AU - Shen,Jianxiong, AU - Zhang,Jianguo, AU - Tian,Ye, AU - Zhao,Hong, AU - Wang,Yipeng, AU - Liang,Jinqian, AU - Li,Zheng, AU - Qiu,Guixing, PY - 2014/9/10/entrez PY - 2014/9/10/pubmed PY - 2015/7/21/medline SP - E1353 EP - 8 JF - Spine JO - Spine VL - 39 IS - 23 N2 - STUDY DESIGN: Retrospective review. OBJECTIVE: To investigate the clinical manifestations and radiological characteristics of Klippel-Feil syndrome (KFS) in congenital scoliosis (CS). To identify the incidence of spinal or extraspinal abnormities in KFS. SUMMARY OF BACKGROUND DATA: KFS is an uncommon condition, characterized as improper segmentation of one or more cervical spine segments. "Scoliosis" is potentially the most common manifestation associated with KFS. However, the clinical manifestations and radiological characteristics of KFS in patients with CS are less reported. METHODS: A total of 516 patients with CS from January 2009 to March 2013 were identified from a single institution. The demographic distribution and clinical and radiographical data were collected. Cervical regions were also designated as high (O-C2), mid (C2-C4), and low (C4-T1). The incidence of intra- and extraspinal abnormalities associated with KFS was investigated. RESULTS: In total, 28 patients (5.42%) had been identified with KFS, which included 8 males and 20 females. The mean coronal cervical alignment was 20.6° and sagittal alignment was 29.9°. KFS type I was found in 14 patients (50.0%), type II in 6 (21.4%), and type III in 8 (28.6%). Congenitally fused cervical segment is more common in the mid and lower cervical spine region (85.7%, 24/28). In the 28 patients with KFS, 11 have intraspinal anomalies (32.1%) and 6 have extraskeletal anomalies (21.4%). Thirteen patients (46.4%) exhibited rib anomalies. The incidence of rib anomalies showed no significant difference in CS patients with KFS and without KFS (P>0.05). A half of the patients with KFS have hemivertebrae; however, the incidence of hemivertebrae showed no significant difference in CS patients with KFS and without KFS (P>0.05). CONCLUSION: The incidence of KFS was 5.42% in patients with CS. Congenitally fused cervical patterns are more common in the mid and lower cervical spine region. The incidence of rib anomalies, intraspinal abnormities, and hemivertebra was not increased in CS patients with KFS. LEVEL OF EVIDENCE: 4. SN - 1528-1159 UR - https://www.unboundmedicine.com/medline/citation/25202932/Klippel_Feil_syndrome_in_congenital_scoliosis_ L2 - http://dx.doi.org/10.1097/BRS.0000000000000587 DB - PRIME DP - Unbound Medicine ER -