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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

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
Authors
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
Citation
Spine, 2008, v. 33 n. 13, p. 1442-1450 How to Cite?
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.
Persistent Identifierhttp://hdl.handle.net/10722/92923
ISSN
2014 Impact Factor: 2.297
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.accessioned2010-09-22T05:03:54Z-
dc.date.available2010-09-22T05:03:54Z-
dc.date.issued2008en_HK
dc.identifier.citationSpine, 2008, v. 33 n. 13, p. 1442-1450en_HK
dc.identifier.issn0362-2436en_HK
dc.identifier.urihttp://hdl.handle.net/10722/92923-
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.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.subjectAtlantodensen_HK
dc.subjectCervicalen_HK
dc.subjectCongenitalen_HK
dc.subjectDevelopmentalen_HK
dc.subjectEpidemiologyen_HK
dc.subjectKlippel-Feilen_HK
dc.subjectPADIen_HK
dc.subjectPediatricen_HK
dc.subjectRisk factorsen_HK
dc.subjectSpace available corden_HK
dc.subjectSpineen_HK
dc.subjectSymptomsen_HK
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 patientsen_HK
dc.typeArticleen_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.0b013e3181753ca6en_HK
dc.identifier.scopuseid_2-s2.0-46749132716en_HK
dc.identifier.hkuros167466-
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-46749132716&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume33en_HK
dc.identifier.issue13en_HK
dc.identifier.spage1442en_HK
dc.identifier.epage1450en_HK
dc.identifier.eissn1528-1159-
dc.identifier.isiWOS:000256433100008-
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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