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Article: 2008 young investigator award: The role of congenitally fused cervical segments upon the space available for the cord and associated symptoms in klippel-feil patients
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Title2008 young investigator award: The role of congenitally fused cervical segments upon the space available for the cord and associated symptoms in klippel-feil patients
 
AuthorsSamartzis, D2 4
Kalluri, P1
Herman, J2
Lubicky, JP5
Shen, FH3 2
 
KeywordsAtlantodens
Cervical
Congenital
Developmental
Epidemiology
Klippel-Feil
PADI
Pediatric
Risk factors
Space available cord
Spine
Symptoms
 
Issue Date2008
 
PublisherLippincott, Williams & Wilkins. The Journal's web site is located at http://www.spinejournal.com
 
CitationSpine, 2008, v. 33 n. 13, p. 1442-1450 [How to Cite?]
DOI: http://dx.doi.org/10.1097/BRS.0b013e3181753ca6
 
AbstractStudy design.: A prospective radiographic and retrospective clinical chart review. Objective.: This study evaluated the role of congenitally fused cervical segments in relation to the space available for the cord (SAC) and associated cervical spine-related symptoms (CSS) in patients with Klippel-Feil Syndrome (KFS). Summary of background data.: KFS is a developmental disorder presenting with congenital fusion of at least 2 cervical vertebrae. The effects of congenitally fused cervical segments in relation to the SAC and associated symptoms in KFS patients remain speculative and have not been thoroughly addressed in the literature. Methods.: At a single institution, a prospective radiographic and clinical evaluation of 29 KFS patients was conducted. Based on plain radiographs, assessment of the SAC consisted of the posterior atlantodens interval, the midvertebral body SAC (C2-C7), and the interbody SAC (C2-C3-C7-T1). Vertebral body width (VBW) from C2 to C7 and the presence of occipitalization (O-C1) were also noted. Torg ratios were obtained at each level. Demographics, medical history, and the presence of CSS were noted based on clinical chart review. Results.: Ten males and 19 females were reviewed (mean age, 13.4 years). A significant correlation was noted between the overall VBWs to the number of fused segments, age, and skeletal maturity (P < 0.05), but not to sex-type, O-C1, and SAC levels (P > 0.05). In the presence of a fused segment, individualized SAC levels tended to have greater canal dimensions and cephalad/caudal VBWs were less. Cephalad and caudal Torg ratios in relation to a segment were greater in all fused segments, and with 4 or greater fused segments (P < 0.05). Number of levels fused, sex-type, skeletal maturity, and O-C1 were not significantly associated with the presence of symptoms (P > 0.05). Symptomatic patients had smaller VBWs than nonsymptomatic patients (P = 0.027) and an overall decrease in SAC at the interbody disc level, primarily at C6-C7 (P > 0.05). Smaller Torg ratios were noted in symptomatic patients, specifically myelopathic patients. Conclusion.: Congenital fusion in KFS may arrest the normal vertebral development, which may affect appositional bone growth. Such effects on the VBW could potentially contribute to an increase in the SAC. Such a development may delay neurologic compromise stemming from the congenital fusion process and subsequent degenerative manifestations. © 2008, Lippincott Williams & Wilkins.
 
ISSN0362-2436
2013 Impact Factor: 2.447
 
DOIhttp://dx.doi.org/10.1097/BRS.0b013e3181753ca6
 
ISI Accession Number IDWOS:000256433100008
 
ReferencesReferences in Scopus
 
DC FieldValue
dc.contributor.authorSamartzis, D
 
dc.contributor.authorKalluri, P
 
dc.contributor.authorHerman, J
 
dc.contributor.authorLubicky, JP
 
dc.contributor.authorShen, FH
 
dc.date.accessioned2010-09-22T05:03:54Z
 
dc.date.available2010-09-22T05:03:54Z
 
dc.date.issued2008
 
dc.description.abstractStudy design.: A prospective radiographic and retrospective clinical chart review. Objective.: This study evaluated the role of congenitally fused cervical segments in relation to the space available for the cord (SAC) and associated cervical spine-related symptoms (CSS) in patients with Klippel-Feil Syndrome (KFS). Summary of background data.: KFS is a developmental disorder presenting with congenital fusion of at least 2 cervical vertebrae. The effects of congenitally fused cervical segments in relation to the SAC and associated symptoms in KFS patients remain speculative and have not been thoroughly addressed in the literature. Methods.: At a single institution, a prospective radiographic and clinical evaluation of 29 KFS patients was conducted. Based on plain radiographs, assessment of the SAC consisted of the posterior atlantodens interval, the midvertebral body SAC (C2-C7), and the interbody SAC (C2-C3-C7-T1). Vertebral body width (VBW) from C2 to C7 and the presence of occipitalization (O-C1) were also noted. Torg ratios were obtained at each level. Demographics, medical history, and the presence of CSS were noted based on clinical chart review. Results.: Ten males and 19 females were reviewed (mean age, 13.4 years). A significant correlation was noted between the overall VBWs to the number of fused segments, age, and skeletal maturity (P < 0.05), but not to sex-type, O-C1, and SAC levels (P > 0.05). In the presence of a fused segment, individualized SAC levels tended to have greater canal dimensions and cephalad/caudal VBWs were less. Cephalad and caudal Torg ratios in relation to a segment were greater in all fused segments, and with 4 or greater fused segments (P < 0.05). Number of levels fused, sex-type, skeletal maturity, and O-C1 were not significantly associated with the presence of symptoms (P > 0.05). Symptomatic patients had smaller VBWs than nonsymptomatic patients (P = 0.027) and an overall decrease in SAC at the interbody disc level, primarily at C6-C7 (P > 0.05). Smaller Torg ratios were noted in symptomatic patients, specifically myelopathic patients. Conclusion.: Congenital fusion in KFS may arrest the normal vertebral development, which may affect appositional bone growth. Such effects on the VBW could potentially contribute to an increase in the SAC. Such a development may delay neurologic compromise stemming from the congenital fusion process and subsequent degenerative manifestations. © 2008, Lippincott Williams & Wilkins.
 
dc.description.naturelink_to_subscribed_fulltext
 
dc.identifier.citationSpine, 2008, v. 33 n. 13, p. 1442-1450 [How to Cite?]
DOI: http://dx.doi.org/10.1097/BRS.0b013e3181753ca6
 
dc.identifier.doihttp://dx.doi.org/10.1097/BRS.0b013e3181753ca6
 
dc.identifier.eissn1528-1159
 
dc.identifier.epage1450
 
dc.identifier.isiWOS:000256433100008
 
dc.identifier.issn0362-2436
2013 Impact Factor: 2.447
 
dc.identifier.issue13
 
dc.identifier.scopuseid_2-s2.0-46749132716
 
dc.identifier.spage1442
 
dc.identifier.urihttp://hdl.handle.net/10722/92923
 
dc.identifier.volume33
 
dc.languageeng
 
dc.publisherLippincott, Williams & Wilkins. The Journal's web site is located at http://www.spinejournal.com
 
dc.publisher.placeUnited States
 
dc.relation.ispartofSpine
 
dc.relation.referencesReferences in Scopus
 
dc.subjectAtlantodens
 
dc.subjectCervical
 
dc.subjectCongenital
 
dc.subjectDevelopmental
 
dc.subjectEpidemiology
 
dc.subjectKlippel-Feil
 
dc.subjectPADI
 
dc.subjectPediatric
 
dc.subjectRisk factors
 
dc.subjectSpace available cord
 
dc.subjectSpine
 
dc.subjectSymptoms
 
dc.title2008 young investigator award: The role of congenitally fused cervical segments upon the space available for the cord and associated symptoms in klippel-feil patients
 
dc.typeArticle
 
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<contributor.author>Shen, FH</contributor.author>
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<description.abstract>Study design.: A prospective radiographic and retrospective clinical chart review. Objective.: This study evaluated the role of congenitally fused cervical segments in relation to the space available for the cord (SAC) and associated cervical spine-related symptoms (CSS) in patients with Klippel-Feil Syndrome (KFS). Summary of background data.: KFS is a developmental disorder presenting with congenital fusion of at least 2 cervical vertebrae. The effects of congenitally fused cervical segments in relation to the SAC and associated symptoms in KFS patients remain speculative and have not been thoroughly addressed in the literature. Methods.: At a single institution, a prospective radiographic and clinical evaluation of 29 KFS patients was conducted. Based on plain radiographs, assessment of the SAC consisted of the posterior atlantodens interval, the midvertebral body SAC (C2-C7), and the interbody SAC (C2-C3-C7-T1). Vertebral body width (VBW) from C2 to C7 and the presence of occipitalization (O-C1) were also noted. Torg ratios were obtained at each level. Demographics, medical history, and the presence of CSS were noted based on clinical chart review. Results.: Ten males and 19 females were reviewed (mean age, 13.4 years). A significant correlation was noted between the overall VBWs to the number of fused segments, age, and skeletal maturity (P &lt; 0.05), but not to sex-type, O-C1, and SAC levels (P &gt; 0.05). In the presence of a fused segment, individualized SAC levels tended to have greater canal dimensions and cephalad/caudal VBWs were less. Cephalad and caudal Torg ratios in relation to a segment were greater in all fused segments, and with 4 or greater fused segments (P &lt; 0.05). Number of levels fused, sex-type, skeletal maturity, and O-C1 were not significantly associated with the presence of symptoms (P &gt; 0.05). Symptomatic patients had smaller VBWs than nonsymptomatic patients (P = 0.027) and an overall decrease in SAC at the interbody disc level, primarily at C6-C7 (P &gt; 0.05). Smaller Torg ratios were noted in symptomatic patients, specifically myelopathic patients. Conclusion.: Congenital fusion in KFS may arrest the normal vertebral development, which may affect appositional bone growth. Such effects on the VBW could potentially contribute to an increase in the SAC. Such a development may delay neurologic compromise stemming from the congenital fusion process and subsequent degenerative manifestations. &#169; 2008, Lippincott Williams &amp; Wilkins.</description.abstract>
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<subject>PADI</subject>
<subject>Pediatric</subject>
<subject>Risk factors</subject>
<subject>Space available cord</subject>
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Author Affiliations
  1. Colonial Orthopedics
  2. Shriners Hospitals for Children - Chicago
  3. University of Virginia
  4. Erasmus University Rotterdam
  5. Indiana University