Cervical disc arthroplasty for Klippel-Feil syndrome

Area of Science:

• Orthopedics and Spine Surgery
• Congenital Musculoskeletal Disorders
• Cervical Spine Biomechanics

Background:

• Klippel-Feil syndrome (KFS) is a congenital condition characterized by cervical spine fusion.
• Surgical management of KFS often involves addressing adjacent segments, posing unique challenges.
• Evaluating treatment outcomes for KFS patients is crucial for optimizing care.

Purpose of the Study:

• To assess the clinical and radiological outcomes of Klippel-Feil syndrome patients treated with cervical disc arthroplasty (CDA).
• To compare CDA with traditional fusion techniques in the KFS population.
• To determine the feasibility and efficacy of CDA in preserving cervical spine mobility in KFS.

Main Methods:

• Retrospective review of 2320 anterior cervical surgery patients.
• Identification and grouping of 41 KFS patients into either CDA or fusion cohorts based on adjacent disc treatment.
• Evaluation using visual analog scales, Neck Disability Index (NDI), Japanese Orthopedic Association (JOA) scores, and range of motion (ROM) metrics.

Main Results:

• KFS prevalence in the cohort was 1.77%; 30 patients with adjacent disc issues were analyzed.
• Both CDA and fusion groups showed improved patient-reported outcomes post-surgery.
• CDA preserved C2-7 and segmental range of motion, unlike the fusion group, which showed a significant decrease in ROM.

Conclusions:

• Klippel-Feil syndrome is a rare condition impacting cervical spine mobility.
• Cervical disc arthroplasty is a feasible and effective treatment for KFS.
• CDA avoids long-segment fusion and successfully preserves segmental and global cervical spine mobility in KFS patients.