What Is a Cervical Spine Fusion?
Congenital malformation of cervical spine is also called poor cervical segmentation. The disease was first reported by Klippel and Feil in 1912, so it is called Klippel-Feil syndrome. It is a fusion deformity of two or more cervical vertebrae, which is manifested by a decrease in the number of cervical vertebrae, shortened necks, restricted head and neck movements, and often accompanied by malformations in other parts. A few patients may have neurological disorders. The patient's neck was shorter than normal, the occipital hairline was reduced, and head movement was restricted.
- nickname
- Poor cervical segmentation, Klippel-Feil syndrome
- English name
- congenital fusion of cervical vertebrae
- English alias
- Klippel-Feil syndrome
- Visiting department
- orthopedics
- Common locations
- Cervical spine
- Common causes
- Cervical spine deformity
- Common symptoms
- Short neck, low back hairline, and limited neck movement
Basic Information
Causes of congenital cervical fusion deformity
- Cervical spine malformation can be the fusion of all cervical vertebrae or several cervical vertebrae, or local fusion of vertebral body, lamina, vertebral arch and spinous process. The cause of the deformity is unclear. Generally, it is believed that during the development of the embryo, the mesenchymal tissue of the intervertebral disc should be developed. When the endplate of the vertebral body matures, the intervertebral disc or cartilage does not occur until ossification, forming intervertebral fusion. A few congenital cervical fusions are genetically related.
Clinical manifestations of congenital cervical fusion deformity
- Congenital cervical fusion deformity has three major clinical features: short and thick neck, low posterior hairline, and limited neck movement, but not all patients have the above characteristics.
- Short neck
- It is usually not obvious, but if you look closely, your neck becomes shorter than normal. The face is asymmetric, and the skin on both sides of the neck from the mastoid to the acromion is widened, showing a winged neck.
- 2. Low hairline after haircut
- The main manifestation is that the posterior hairline is significantly lower than that of normal people.
- 3. Limited cervical spine
- Due to the fusion of the vertebrae, the range of motion of the cervical spine is significantly limited, and the rotation and lateral curvature are particularly limited. Multi-segment and full-segment fusion activities are significantly limited, and single-segment and lower-segment fusion are less obvious.
- 4. Short neck deformity caused by upper cervical spine fusion, often with occipital neck deformity
- Neurological symptoms often appear in the early stages, mainly manifested as spinal cord compression caused by instability of the pillow.
- 5. Short-neck deformity caused by mid-low cervical fusion
- Almost all of these patients have obvious neurological symptoms after minor trauma. Its clinical features are mild trauma and severe symptoms, which can cause paralysis of the limbs, and X-ray examination does not show obvious signs of bone damage.
- 6. Short neck deformity with cervical ribs, recessive spina bifida, nerve root or plexus distribution deformity
- Arm pain, low back pain, and sciatica can occur. Patients with cardiac malformation and renal malformation will also have corresponding clinical symptoms. In addition, short neck deformities can be combined with scoliosis, high scapula and webbed deformities.
Congenital cervical fusion deformity examination
- 1. X-ray inspection
- The location and shape of the congenital developmental fusion malformation of the cervical spine can be found on conventional radiographs of the cervical spine and lateral X-rays. Of these, bivertebral fusion is more common, and few with more than three sections. According to the needs of the disease, left and right oblique and dynamic lateral radiographs can be added to comprehensively observe the range of vertebral deformity and intervertebral stability.
- 2. Magnetic resonance imaging examination
- For those with symptoms of nerve compression, MRI can be sought, and CT or myelography can be performed to determine the spinal canal status and spinal cord involvement.
Diagnosis of congenital cervical fusion deformity
- According to the clinical manifestations of the disease, X-ray examination and CT examination are sufficient to confirm the diagnosis of cervical fusion deformity.
- The diagnosis of this disease is generally without difficulty, mainly based on:
- Congenital
- Seen abnormally after birth.
- 2. Neck deformity
- It is mainly a short neck malformation, and most cases can be judged clinically. Pay attention to observe the scalp hairline height and cervical spine movement limitation, and check the whole body for other malformations.
- 3. Imaging examination
- Most cases can be confirmed by plain radiographs.
Treatment of congenital cervical fusion deformity
- The choice of cervical spine fusion deformity treatment plan is mainly based on the number and location of deformed vertebral bodies, and the symptomatic treatment of neurological symptoms.
- 1. Short neck deformity caused by simple middle and lower cervical spine fusion
- In the early stage, there are often no neurological symptoms and no special treatment is needed, but care should be taken to avoid excessive cervical spine movement, prevent trauma, and delay the process of cervical degeneration. For those with ugly appearance of the neck, bilateral "Z" plastic surgery or double skin Lateral sternocleidomastoid amputation improves appearance. Patients with spinal cord compression due to cervical spine stenosis due to cervical degeneration in the late stage can undergo anterior or posterior decompression according to the compression site of the spinal cord.
- 2. Short neck deformity caused by upper cervical spine fusion
- Neurological symptoms can occur early and should be given high attention. For those without neurological symptoms, follow-up observation should be performed to prevent neck trauma, reduce neck movement or local cervical fixation. For those with neurological symptoms, corresponding decompression and stable surgery can be used.
- 3. Short neck deformity trauma combined with spinal cord injury without bone injury
- Non-surgical treatment should be used first, such as skull traction or occipital-jaw traction. Symptoms should be fixed with head and neck and chest plaster after the symptoms disappear; those with obvious fractures and dislocations should first be restored with skull traction, and then choose a treatment plan based on changes in neurological symptoms.
- 4. For short neck deformity combined with other abnormalities such as
- Scoliosis, cardiac malformation, renal malformation, and occipital and neck deformities should be treated accordingly.