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Article: The extent of fusion within the congenital klippel-feil segment

TitleThe extent of fusion within the congenital klippel-feil segment
Authors
KeywordsAge
Cervical
Fusion
Klippel-Feil
Patterns
Segmentation
Skeletal maturity
Spine
Issue Date2008
PublisherLippincott, Williams & Wilkins. The Journal's web site is located at http://www.spinejournal.com
Citation
Spine, 2008, v. 33 n. 15, p. 1637-1642 How to Cite?
AbstractStudy Design. Retrospective radiographic review. Objective. To evaluate in patients with Klippel-Feil syndrome (KFS) the presence and extent of specific fusion patterns across involved cervical segments and their association with age-specific parameters. Summary of Background Data. While the radiographic hallmark of KFS is characterized by congenital fusion of at least one cervical motion segment, the relation between age and the extent of segmental congenital fusion remains speculative. Methods. A radiographic review of 31 patients with KFS at a single institution. Plain radiographs were used to assess fusion across the vertebral segment as entailing the anterior elements, posterior elements, or complete segment from O-T1. Age-specific stratifications were also performed. Results. A mean of 3.7 fused segments and a sum of 116 fused segments were noted. From C2-T1, complete fusion of the involved segment represented 77.8% at 10 years or older, 87.5% at 15 years or older, 91.7% at 16 years or older, 95.7% at 17 years or older, 86.5% who were skeletally mature, and 100% at adulthood. Similar trends were not noted for segments of O-C2. In absence of complete segmental fusion, the posterior elements exhibited a higher incidence of fusion than the anterior elements. Statistically significant differences between anterior/posterior to complete segmental fusion with respect to different age markers entailed segments of C2-C3, C4-C5, and C6-C7 (P < 0.05). Conclusion. This study provides some insight into the potential developmental aspects of the extent of segmental fusion of the cervical spine in patients with KFS. In older patients, complete fusion of involved fused segments was more prevalent in regards to C2-T1; however, such an observation was not noted for segments from O-C2. In the absence of complete segmental fusion, fusion of the posterior elements was more often noted than fusion of the anterior elements. Awareness of the varied phenotypic expression of segmental fusion patterns of the cervical spine in patients with KFS underlines theimportance of thorough evaluation of the cervical spine to assess the presence and extent of segmental fusion to facilitate in the identification of neurologic risk factors. © 2008 Lippincott Williams & Wilkins.
Persistent Identifierhttp://hdl.handle.net/10722/59464
ISSN
2015 Impact Factor: 2.439
2015 SCImago Journal Rankings: 1.459
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorSamartzis, Den_HK
dc.contributor.authorKalluri, Pen_HK
dc.contributor.authorHerman, Jen_HK
dc.contributor.authorLubicky, JPen_HK
dc.contributor.authorShen, FHen_HK
dc.date.accessioned2010-05-31T03:50:45Z-
dc.date.available2010-05-31T03:50:45Z-
dc.date.issued2008en_HK
dc.identifier.citationSpine, 2008, v. 33 n. 15, p. 1637-1642en_HK
dc.identifier.issn0362-2436en_HK
dc.identifier.urihttp://hdl.handle.net/10722/59464-
dc.description.abstractStudy Design. Retrospective radiographic review. Objective. To evaluate in patients with Klippel-Feil syndrome (KFS) the presence and extent of specific fusion patterns across involved cervical segments and their association with age-specific parameters. Summary of Background Data. While the radiographic hallmark of KFS is characterized by congenital fusion of at least one cervical motion segment, the relation between age and the extent of segmental congenital fusion remains speculative. Methods. A radiographic review of 31 patients with KFS at a single institution. Plain radiographs were used to assess fusion across the vertebral segment as entailing the anterior elements, posterior elements, or complete segment from O-T1. Age-specific stratifications were also performed. Results. A mean of 3.7 fused segments and a sum of 116 fused segments were noted. From C2-T1, complete fusion of the involved segment represented 77.8% at 10 years or older, 87.5% at 15 years or older, 91.7% at 16 years or older, 95.7% at 17 years or older, 86.5% who were skeletally mature, and 100% at adulthood. Similar trends were not noted for segments of O-C2. In absence of complete segmental fusion, the posterior elements exhibited a higher incidence of fusion than the anterior elements. Statistically significant differences between anterior/posterior to complete segmental fusion with respect to different age markers entailed segments of C2-C3, C4-C5, and C6-C7 (P < 0.05). Conclusion. This study provides some insight into the potential developmental aspects of the extent of segmental fusion of the cervical spine in patients with KFS. In older patients, complete fusion of involved fused segments was more prevalent in regards to C2-T1; however, such an observation was not noted for segments from O-C2. In the absence of complete segmental fusion, fusion of the posterior elements was more often noted than fusion of the anterior elements. Awareness of the varied phenotypic expression of segmental fusion patterns of the cervical spine in patients with KFS underlines theimportance of thorough evaluation of the cervical spine to assess the presence and extent of segmental fusion to facilitate in the identification of neurologic risk factors. © 2008 Lippincott Williams & Wilkins.en_HK
dc.languageengen_HK
dc.publisherLippincott, Williams & Wilkins. The Journal's web site is located at http://www.spinejournal.comen_HK
dc.relation.ispartofSpineen_HK
dc.subjectAgeen_HK
dc.subjectCervicalen_HK
dc.subjectFusionen_HK
dc.subjectKlippel-Feilen_HK
dc.subjectPatternsen_HK
dc.subjectSegmentationen_HK
dc.subjectSkeletal maturityen_HK
dc.subjectSpineen_HK
dc.subject.meshAdolescent-
dc.subject.meshAdult-
dc.subject.meshChi-Square Distribution-
dc.subject.meshChild-
dc.subject.meshKlippel-Feil Syndrome - pathology - radiography-
dc.titleThe extent of fusion within the congenital klippel-feil segmenten_HK
dc.typeArticleen_HK
dc.identifier.openurlhttp://library.hku.hk:4550/resserv?sid=HKU:IR&issn=0362-2436&volume=33&issue=15&spage=1637&epage=1642&date=2008&atitle=The+extent+of+fusion+within+the+congenital+Klippel-Feil+segmenten_HK
dc.identifier.emailSamartzis, D:dspine@hku.hken_HK
dc.identifier.authoritySamartzis, D=rp01430en_HK
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.doi10.1097/BRS.0b013e31817c0bc2en_HK
dc.identifier.pmid18594455-
dc.identifier.scopuseid_2-s2.0-50949124647en_HK
dc.identifier.hkuros167468en_HK
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-50949124647&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume33en_HK
dc.identifier.issue15en_HK
dc.identifier.spage1637en_HK
dc.identifier.epage1642en_HK
dc.identifier.isiWOS:000257393600004-
dc.publisher.placeUnited Statesen_HK
dc.identifier.scopusauthoridSamartzis, D=34572771100en_HK
dc.identifier.scopusauthoridKalluri, P=13609327300en_HK
dc.identifier.scopusauthoridHerman, J=7403275959en_HK
dc.identifier.scopusauthoridLubicky, JP=7004313450en_HK
dc.identifier.scopusauthoridShen, FH=7201583245en_HK

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