Klippel-Feil syndrome - The risk of cervical spinal cord injury: A casereport

被引:40
作者
Vaidyanathan S. [1 ]
Hughes P.L. [2 ]
Soni B.M. [1 ]
Singh G. [1 ]
Sett P. [1 ]
机构
[1] Regional Spinal Injuries Centre, District General Hospital, Southport
[2] Department of Radiology, District General Hospital, Southport
关键词
Spinal Cord Injury; Kidney Stone; Minor Trauma; Renal Anomaly; Cervical Spinal Cord Injury;
D O I
10.1186/1471-2296-3-6
中图分类号
学科分类号
摘要
Background: Klippel-Feil syndrome is defined as congenital fusion of two or more cervical vertebrae and is believed to result from faulty segmentation along the embryo's developing axis during weeks 3-8 of gestation. Persons with Klippel-Feil syndrome and cervical stenosis may be at increased risk for spinal cord injury after minor trauma as a result of hypermobility of the various cervical segments. Persons with Klippel-Feil Syndrome often have congenital anomalies of the urinary tract as well. Case presentation: A 51-year male developed incomplete tetraplegia in 1997 when he slipped and fell backwards hitting his head on the floor. X-rays of cervical spine showed fusion at two levels: C2 and C3 vertebrae, and C4 and C5 vertebrae. Intravenous urography (IVU) revealed no kidneys in the renal fossa on both sides, but the presence of crossed, fused renal ectopia in the left ilio-lumbar region. This patient had a similar cervical spinal cord injury about 15 years ago, when he developed transient numbness and paresis of the lower limbs following a fall. Discussion and Conclusion: 1) Persons with Klippel-Feil syndrome should be made aware of the increased risk of sustaining transient neurologic deterioration after minor trauma if there is associated radiographic evidence of spinal stenosis. 2) Patients with Klippel-Feil syndrome often have congenital anomalies of the urinary tract. Our patient had crossed, fused, ectopia of kidney. 3) When patients with Klippel-Feil syndrome sustain tetraplegia they have increased chances of developing urinary tract calculi. Treatment of kidney stones may pose a challenge because of associated renal anomalies. 4) Health professionals caring for cervical spinal cord injury patients with Klippel-Feil syndrome and renal anomalies should place emphasis on prevention of kidney stones. A large fluid intake is recommended for these patients, as a high intake of fluids is still the most powerful and certainly the most economical means of prevention of nephrolithiasis.
引用
收藏
页码:1 / 5
页数:4
相关论文
共 12 条
  • [1] Strax T.E., Baran E., Traumatic quadriplegia associated with Klippel-Feil syndrome: Discussion and case reports, Arch Phys Med Rehabil, 56, pp. 363-365, (1975)
  • [2] Karasick D., Schweitzer M.E., Vaccaro A.R., The traumatized cervical spine in Klippel-Feil syndrome: Imaging features, A JR Am J Roentgenol, 170, pp. 85-88, (1998)
  • [3] Elster A.D., Quadriplegia after minor trauma in the Klippel-Feil syndrome: A case report and review of the literature, J Bone Joint Surg Am, 66, pp. 1473-1474, (1984)
  • [4] Vaidyanathan S., Glass C.A., Soni B.M., Bingley J., Singh G., Watt J.W.H., Sett P., Doctor-Patient Communication: Do people with spinal cord injury wish to receive written information about their medical condition from the physicians after an outpatient visit or after a readmission in the spinal unit?, Spinal Cord, 39, pp. 650-653, (2001)
  • [5] Moore W.B., Matthews T.J., Rabinowitz R., Genitourinary anomalies associated with Klippel-Feil syndrome, J Bone Joint Surg Am, 57, pp. 355-357, (1975)
  • [6] Vaidyanathan S., Soni B.M., Biering-Sorensen F., Bagi P., Wallberg A.H., Vidal J., Borau A., Singh G., Sett P., Krishnan K.R., Recurrent bilateral renal calculi in a tetraplegic patient, Spinal Cord, 36, pp. 454-462, (1998)
  • [7] Chen Y., DeVivo M.J., Roseman J.M., Current trend and risk factors for kidney stones in persons with spinal cord injury: A longitudinal study, Spinal Cord, 38, pp. 346-353, (2000)
  • [8] Vaidyanathan S., Parsons K.F., Krishnan K.R., Soni B.M., Singh G., Sett P., What is the optimum fluid intake in male patients with spinal cord injury and neuropathic bladder?, Spinal Cord, 37, pp. 594-595, (1999)
  • [9] Pak C.Y., Medical prevention of renal stone disease, Nephron, 81, pp. 60-65, (1999)
  • [10] Pearle M.S., Prevention of nephrolithiasis, Curr Opin Nephrol Hypertens, 10, pp. 203-209, (2001)