C7 laminar fracture and Klippel-Feil syndrome

Case contributed by Mohamed Mahmoud Elthokapy

Presentation

Post road traffic accident with neck pain and restricted movement

Patient Data

Age: 40 years
Gender: Female

Post-traumatic study revealed:

  • right C7 laminar fracture with no displacement
  • C3 hemivertebra with congenitally fused C2, C3 and C4 vertebral bodies with reduced AP diameter as well as fused their neural arches
Annotated image

Right C7 laminar fracture.

The previously noted right C7 laminar fracture is once again seen with bright STIR marrow signal associated with nearby posterior soft tissue signal alteration of bright T2 and STIR suggesting soft tissue edema/bruises.

C6/7 right postero-lateral focal disc protrusion is noted elevating underlying PLL (that appears intact) and slightly encroaching on the right exit neural foramen.

C3 hemivertebra with congenitally fused C2, C3 and C4 vertebral bodies with reduced their AP diameters as well as fused their neural arches with rudimentary intervening discs in-between.

Case Discussion

Post-traumatic case revealed a C7 laminar fracture with mild soft tissue injury.

Incidental fusion of two or more cervical vertebrae is sufficient to make the diagnosis of Klippel-Feil syndrome type II.

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