Abstract
Cervical arthroplasty may be justified in patients with Klippel-Feil syndrome (KFS) in order to preserve cervical motion. The aim of this paper is to report an arthroplasty failure in a patient with KFS. A 36-year-old woman with KFS underwent two-level arthroplasty for adjacent segment disc degeneration. Anterior migration of the cranial prosthesis was encountered 5 months postoperatively and was successfully revised with anterior cervical fusion. Cervical arthroplasty in an extensively stiff and fused neck is challenging and may lead to catastrophic failure. Although motion preservation is desirable in KFS, the special biomechanical features may hinder arthroplasty. Fusion or hybrid constructs may represent more reasonable options, especially when multiple fused segments are present.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Baaj AA, Uribe JS, Vale FL, Preul MC, Crawford NR. History of cervical disc arthroplasty. Neurosurg Focus 2009;27:E10.
Eck JC, Humphreys SC, Lim TH, Jeong ST, Kim JG, Hodges SD, et al. Biomechanical study on the effect of cervical spine fusion on adjacent-level intradiscal pressure and segmental motion. Spine (Phila Pa 1976) 2002;27:2431–4.
Goffin J, Casey A, Kehr P, Liebig K, Lind B, Logroscino C, et al. Preliminary clinical experience with the Bryan Cervical Disc Prosthesis. Neurosurgery 2002;51:840–5.
Robertson JT, Papadopoulos SM, Traynelis VC. Assessment of adjacent-segment disease in patients treated with cervical fusion or arthroplasty: A prospective 2-year study. J Neurosurg Spine 2005;3:417–23.
Kim SW, Limson MA, Kim SB, Arbatin JJ, Chang KY, Park MS, et al. Comparison of radiographic changes after ACDF versus Bryan disc arthroplasty in single and bi-level cases. Eur Spine J 2009;18:218–31.
Denaro V, Papalia R, Denaro L, Di Martino A, Maffulli N. Cervical spinal disc replacement. J Bone Joint Surg Br 2009;91:713–9.
Pickett GE, Sekhon LH, Sears WR, Duggal N. Complications with cervical arthroplasty. J Neurosurg Spine 2006;4:98–105.
Goffin J, Van Calenbergh F, van Loon J, Casey A, Kehr P, Liebig K, et al. Intermediate follow-up after treatment of degenerative disc disease with the Bryan Cervical Disc Prosthesis: Single-level and bi-level. Spine (Phila Pa 1976) 2003;28:2673–8.
Yi S, Kim KN, Yang MS, Yang JW, Kim H, Ha Y, et al. Difference in occurrence of heterotopic ossification according to prosthesis type in the cervical artificial disc replacement. Spine (Phila Pa 1976) 2010;35:1556–61.
Tracy MR, Dormans JP, Kusumi K. Klippel-Feil syndrome: Clinical features and current understanding of etiology. Clin Orthop Relat Res 2004;424:183–90.
Klimo P Jr, Rao G, Brockmeyer D. Congenital anomalies of the cervical spine. Neurosurg Clin N Am 2007;18:463–78.
Smoker WR, Khanna G. Imaging the craniocervical junction. Childs Nerv Syst 2008;24:1123–45.
Crockard HA, Stevens JM. Craniovertebral junction anomalies in inherited disorders: Part of the syndrome or caused by the disorder? Eur J Pediatr 1995;154:504–12.
Samartzis DD, Herman J, Lubicky JP, Shen FH. Classification of congenitally fused cervical patterns in Klippel-Feil patients: Epidemiology and role in the development of cervical spine-related symptoms. Spine (Phila Pa 1976) 2006;31:E798–804.
Clarke RA, Catalan G, Diwan AD, Kearsley JH. Heterogeneity in Klippel-Feil syndrome: A new classification. Pediatr Radiol 1998;28:967–74.
Leung CH, Ma WK, Poon WS. Bryan artificial cervical disc arthroplasty in a patient with Klippel-Feil syndrome. Hong Kong Med J 2007;13:399–402.
Yi S, Kim SH, Shin HC, Kim KN, Yoon DH. Cervical arthroplasty in a patient with Klippel-Feil syndrome. Acta Neurochir (Wien) 2007;149:805–9.
Cardoso MJ, Rosner MK. Multilevel cervical arthroplasty with artificial disc replacement. Neurosurg Focus 2010;28:E19.
Cho BY, Lim J, Sim HB, Park J. Biomechanical analysis of the range of motion after placement of a two-level cervical ProDisc-C versus hybrid construct. Spine (Phila Pa 1976) 2010;35:1769–76.
Barbagallo GM, Assietti R, Corbino L, Olindo G, Foti PV, Russo V, et al. Early results and review of the literature of a novel hybrid surgical technique combining cervical arthrodesis and disc arthroplasty for treating multilevel degenerative disc disease: Opposite or complementary techniques? Eur Spine J 2009;18:29–39.
Schwab JS, Diangelo DJ, Foley KT. Motion compensation associated with single-level cervical fusion: Where does the lost motion go? Spine (Phila Pa 1976) 2006;31:2439–48.
Cunningham BW, Hu N, Zorn CM, McAfee PC. Biomechanical comparison of single- and two-level cervical arthroplasty versus arthrodesis: Effect on adjacent-level spinal kinematics. Spine J 2010;10:341–9.
Dmitriev AE, Cunningham BW, Hu N, Sell G, Vigna F, McAfee PC. Adjacent level intradiscal pressure and segmental kinematics following a cervical total disc arthroplasty: An in vitro human cadaveric model. Spine (Phila Pa 1976) 2005;30:1165–72.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Papanastassiou, I.D., Baaj, A.A., Dakwar, E. et al. Failure of cervical arthroplasty in a patient with adjacent segment disease associated with Klippel-Feil syndrome. IJOO 45, 174–177 (2011). https://doi.org/10.4103/0019-5413.77139
Published:
Issue Date:
DOI: https://doi.org/10.4103/0019-5413.77139