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Klippel-Feil 综合征的诊断与管理的综合方法

A Comprehensive Approach to the Diagnosis and Management of Klippel Feil Syndrome.

机构信息

Department of Radiology, National Institute of Child health, Karachi, Pakistan.

Department of Internal Medicine, Dow University of Health Sciences, Karachi, Pakistan.

出版信息

Arch Razi Inst. 2023 Dec 30;78(6):1868-1872. doi: 10.32592/ARI.2023.78.6.1868. eCollection 2023 Dec.

Abstract

Klippel-Feil Syndrome (KFS) is a rare genetic disorder characterized by the abnormal development of the cervical spine, leading to the fusion of two or more cervical vertebrae. The syndrome presents diverse symptoms, including limited neck movement, chronic pain, and neurological manifestations such as limb numbness or weakness. The severity of KFS can vary significantly, and treatment primarily focuses on symptom management and preventing complications such as scoliosis or spinal cord compression. Surgical interventions are often necessary for patients with complex forms of the syndrome. Interestingly, Chiari 1 malformation, a cranial anomaly affecting the brainstem, can coincide anatomically with KFS. In this case report, we present the case of a 9-year-old patient who sought medical attention due to persistent, unchanging neck pain. The patient's medical history was notable for developmental delays and cervical restraint observed during physical examination. Magnetic resonance imaging (MRI) findings revealed hydrocephalus and brainstem descent, indicating the presence of Chiari 1 malformation. Comprehensive MRI and CT scans were performed, and a management plan was formulated, primarily involving cranial surgery and physiotherapy. Implementation of the treatment approach resulted in significant improvement in the patient's symptoms. This case highlights the significance of considering Chiari 1 malformation as a potential comorbidity in patients diagnosed with KFS who present with persistent neck pain. Early detection and appropriate management of both conditions are crucial for achieving favorable outcomes and enhancing the quality of life for affected individuals. Understanding the complex interplay between KFS and Chiari 1 malformation is essential for providing comprehensive care and tailored treatment strategies. Further research is warranted to elucidate the underlying mechanisms linking these two conditions and to explore optimal management approaches for patients with dual pathology. By reporting this case, we contribute to the existing literature and increase awareness among healthcare professionals regarding the potential coexistence of KFS and Chiari 1 malformation. Continued efforts in identifying associated anomalies and optimizing therapeutic interventions will aid in improving patient outcomes and ensuring optimal care for individuals affected by these conditions.

摘要

克莱佩尔-费尔综合征(Klippel-Feil Syndrome,KFS)是一种罕见的遗传性疾病,其特征是颈椎发育异常,导致两个或多个颈椎融合。该综合征表现出多种症状,包括颈部活动受限、慢性疼痛以及肢体麻木或无力等神经系统表现。KFS 的严重程度差异很大,治疗主要侧重于症状管理和预防脊柱侧凸或脊髓受压等并发症。对于患有复杂形式综合征的患者,手术干预通常是必要的。有趣的是,颅底凹陷症(Chiari 1 畸形)一种影响脑干的颅面异常,在解剖学上可与 KFS 同时存在。在本病例报告中,我们介绍了一位 9 岁患者的病例,该患者因持续不变的颈部疼痛寻求医疗。患者的病史有发育迟缓以及体检时观察到的颈部限制。磁共振成像(Magnetic Resonance Imaging,MRI)结果显示脑积水和脑干下降,表明存在 Chiari 1 畸形。进行了全面的 MRI 和 CT 扫描,并制定了管理计划,主要包括颅部手术和物理治疗。实施治疗方法后,患者的症状显著改善。该病例强调了在出现持续性颈部疼痛的 KFS 患者中,将 Chiari 1 畸形视为潜在合并症的重要性。早期发现和适当管理这两种情况对于实现良好的结果和提高受影响个体的生活质量至关重要。了解 KFS 和 Chiari 1 畸形之间的复杂相互作用对于提供全面护理和制定个体化治疗策略至关重要。进一步的研究对于阐明这两种情况之间的潜在机制以及探索患有双重病理的患者的最佳管理方法是必要的。通过报告该病例,我们为现有文献做出了贡献,并提高了医疗保健专业人员对 KFS 和 Chiari 1 畸形同时存在的认识。继续努力识别相关异常并优化治疗干预措施将有助于改善患者的预后并确保为受这些情况影响的个体提供最佳护理。

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