OVERVIEW
Overview of Short Neck Deformity
Short neck deformity is a fused deformity of two or more cervical vertebrae without reduction in the number of cervical vertebrae, characterized by shortening of the cervical neck length, limitation of head and neck movement, and often accompanied by deformities in other parts of the body, and in a few patients, neurological disorders.
Whether medical insurance
Yes
Department
Orthopedics
Alias
Congenital fusion deformity of the cervical spine, cervical malunion, Klippel-Feil syndrome
Clinical symptoms
Short and thick neck, low posterior hairline, limited neck movement.
Harms
Short neck deformity is often combined with other deformities, 60% combined with spinal deformity, 35% combined with renal deformity, and 30% combined with deafness.
Complications
Acute cervical disc herniation, cervical spondylosis, cervical instability, cervical subluxation, etc.
Examination
X-ray examination, CT and three-dimensional reconstruction, magnetic resonance imaging examination, etc.
Diagnosis
Most cases can be diagnosed by X-ray.
Treatment principle
Those without neurological symptoms should be followed up for observation; those with neurological symptoms can be treated with appropriate symptomatic or surgical treatments.
Curability
Aggressive treatment can improve symptoms and prevent complications.
Dietary recommendations
Normal diet and balanced nutrition.
Etiology
Etiology
It is usually thought to be the result of a developmental disorder of the mesenchymal tissue that is supposed to form the intervertebral disc during embryonic development.
Symptoms and Diagnosis
Typical symptoms
1. The short and thick neck is often not obvious, but on close examination the neck is shorter than normal. Facial asymmetry, widening of the skin on both sides of the neck from the mastoid process to the acromion, showing a winged neck. 2. Low posterior hairline is mainly manifested as the posterior hairline is significantly lower than that of normal people. 3. Cervical spine activity is restricted due to the fusion of vertebrae, so that the cervical spine’s range of motion is significantly limited, and the restriction of rotation and lateral bending is particularly obvious. 4. Restriction of activity is obvious in multi-segment and full-segment fusion, and less obvious in single-segment and lower-segment fusion.4. Short neck deformity caused by upper cervical fusion is often combined with occipital-cervical deformity and most of the neurological symptoms appear in the early stage, which mainly manifests as spinal cord compression caused by occipital instability.5. Short neck deformity caused by middle and lower cervical fusion is a type of short neck deformity which almost always occurs in patients who suffer from minor trauma and develop obvious neurological symptoms. Its clinical characteristics are mild trauma, heavy symptoms, can cause quadriplegia, and X-ray examination does not show obvious signs of bone damage.
Other symptoms
Short neck deformity combined with cervical ribs, occult spina bifida, nerve root or plexus distribution deformity may present with brachial pain, lumbago and sciatica. The combination of cardiac malformations and renal malformations may also present with corresponding clinical symptoms. In addition, short neck deformity may be combined with scoliosis, high scapula and webbing deformity.
Diagnostic basis
1. Congenital cervical anomalies do not show up after birth, but are gradually detected during later development. 2. Neck deformities are mainly short neck deformities, which can be determined clinically in most cases; pay attention to the height of the hairline in the scalp and the restriction of cervical spine movement, etc., and check the whole body for other deformities. 3. Imaging examination can be used to confirm the diagnosis of the majority of cases through X-rays. 4.
Treatment
Treatment guidelines
According to the number and location of deformed vertebrae and the presence or absence of neurological symptoms, symptomatic treatment can be provided.
Surgical treatment
1. For short neck deformity caused by simple middle and lower cervical fusion. For those with ugly neck, bilateral neck skin “Z” shaped plasty or bilateral sternocleidomastoid muscle amputation can be used to improve the appearance. For spinal cord compression due to spinal stenosis caused by cervical degeneration in the late stage, anterior or posterior decompression can be performed according to the site of spinal cord compression.2. For short neck deformity caused by fusion of upper cervical vertebrae and neurological symptoms, decompression and stabilization surgeries can be performed accordingly.
Other treatments
Short neck deformity trauma combined to cause spinal cord injury but not accompanied by bony injury, should first use non-surgical treatment, such as cranial traction or occipitomandibular band traction, after the disappearance of the symptoms of the head, neck and thoracic cast immobilization. The cervical spine should be protected with cervical braces.
Prognosis
The prognosis of simple cervical vertebral deformity is good, and there is usually no adverse reaction; those with spinal stenosis or spinal cord compression symptoms have different prognoses depending on the degree of spinal cord involvement.
Nursing care
Daily care
1. Follow-up observers should pay attention to avoiding excessive cervical spine activity and preventing trauma. 2. Periodic review.
Diet
Normal diet, pay attention to nutritional balance.
Other precautions
Protect the cervical spine.