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Abnormal vertebral segmentation and fusion

MedGen UID:
870713
Concept ID:
C4025167
Anatomical Abnormality
HPO: HP:0005640

Term Hierarchy

CClinical test,  RResearch test,  OOMIM,  GGeneReviews,  VClinVar  
  • CROGVAbnormal vertebral segmentation and fusion

Conditions with this feature

Keratoconus posticus circumscriptus
MedGen UID:
340922
Concept ID:
C1855645
Disease or Syndrome
Klippel-Feil syndrome 1, autosomal dominant
MedGen UID:
396196
Concept ID:
C1861689
Disease or Syndrome
Klippel-Feil syndrome is a bone disorder characterized by the abnormal joining (fusion) of two or more spinal bones in the neck (cervical vertebrae). The vertebral fusion is present from birth. Three major features result from this vertebral fusion: a short neck, the resulting appearance of a low hairline at the back of the head, and a limited range of motion in the neck. Most affected people have one or two of these characteristic features. Less than half of all individuals with Klippel-Feil syndrome have all three classic features of this condition.\n\nIn people with Klippel-Feil syndrome, the fused vertebrae can limit the range of movement of the neck and back as well as lead to chronic headaches and muscle pain in the neck and back that range in severity. People with minimal bone involvement often have fewer problems compared to individuals with several vertebrae affected. The shortened neck can cause a slight difference in the size and shape of the right and left sides of the face (facial asymmetry). Trauma to the spine, such as a fall or car accident, can aggravate problems in the fused area. Fusion of the vertebrae can lead to nerve damage in the head, neck, or back. Over time, individuals with Klippel-Feil syndrome can develop a narrowing of the spinal canal (spinal stenosis) in the neck, which can compress and damage the spinal cord. Rarely, spinal nerve abnormalities may cause abnormal sensations or involuntary movements in people with Klippel-Feil syndrome. Affected individuals may develop a painful joint disorder called osteoarthritis around the areas of fused bone or experience painful involuntary tensing of the neck muscles (cervical dystonia). In addition to the fused cervical bones, people with this condition may have abnormalities in other vertebrae. Many people with Klippel-Feil syndrome have abnormal side-to-side curvature of the spine (scoliosis) due to malformation of the vertebrae; fusion of additional vertebrae below the neck may also occur.\n\nPeople with Klippel-Feil syndrome may have a wide variety of other features in addition to their spine abnormalities. Some people with this condition have hearing difficulties, eye abnormalities, an opening in the roof of the mouth (cleft palate), genitourinary problems such as abnormal kidneys or reproductive organs, heart abnormalities, or lung defects that can cause breathing problems. Affected individuals may have other skeletal defects including arms or legs of unequal length (limb length discrepancy), which can result in misalignment of the hips or knees. Additionally, the shoulder blades may be underdeveloped so that they sit abnormally high on the back, a condition called Sprengel deformity. Rarely, structural brain abnormalities or a type of birth defect that occurs during the development of the brain and spinal cord (neural tube defect) can occur in people with Klippel-Feil syndrome.\n\nIn some cases, Klippel-Feil syndrome occurs as a feature of another disorder or syndrome, such as Wildervanck syndrome or hemifacial microsomia. In these instances, affected individuals have the signs and symptoms of both Klippel-Feil syndrome and the additional disorder.

Professional guidelines

PubMed

Jae-Min Park A, Nelson SE, Mesfin A
JBJS Rev 2022 Feb 15;10(2) doi: 10.2106/JBJS.RVW.21.00166. PMID: 35171878
Litrenta J, Bi AS, Dryer JW
J Am Acad Orthop Surg 2021 Nov 15;29(22):951-960. doi: 10.5435/JAAOS-D-21-00190. PMID: 34288888
Mackel CE, Jada A, Samdani AF, Stephen JH, Bennett JT, Baaj AA, Hwang SW
Childs Nerv Syst 2018 Nov;34(11):2155-2171. Epub 2018 Aug 4 doi: 10.1007/s00381-018-3915-6. PMID: 30078055

Recent clinical studies

Etiology

Jae-Min Park A, Nelson SE, Mesfin A
JBJS Rev 2022 Feb 15;10(2) doi: 10.2106/JBJS.RVW.21.00166. PMID: 35171878
Lee CY, Wu CL, Chang HK, Wu JC, Huang WC, Cheng H, Tu TH
Clin Neurol Neurosurg 2021 Oct;209:106934. Epub 2021 Sep 3 doi: 10.1016/j.clineuro.2021.106934. PMID: 34543827
Huang PJ, Lin JH, Chiang YH
World Neurosurg 2020 Jun;138:e634-e641. Epub 2020 Mar 13 doi: 10.1016/j.wneu.2020.03.023. PMID: 32173550
Mackel CE, Jada A, Samdani AF, Stephen JH, Bennett JT, Baaj AA, Hwang SW
Childs Nerv Syst 2018 Nov;34(11):2155-2171. Epub 2018 Aug 4 doi: 10.1007/s00381-018-3915-6. PMID: 30078055
Arlet V, Odent T, Aebi M
Eur Spine J 2003 Oct;12(5):456-63. Epub 2003 Jun 14 doi: 10.1007/s00586-003-0555-6. PMID: 14618384Free PMC Article

Diagnosis

Jae-Min Park A, Nelson SE, Mesfin A
JBJS Rev 2022 Feb 15;10(2) doi: 10.2106/JBJS.RVW.21.00166. PMID: 35171878
Litrenta J, Bi AS, Dryer JW
J Am Acad Orthop Surg 2021 Nov 15;29(22):951-960. doi: 10.5435/JAAOS-D-21-00190. PMID: 34288888
Frikha R
Clin Dysmorphol 2020 Jan;29(1):35-37. doi: 10.1097/MCD.0000000000000301. PMID: 31577545
Mackel CE, Jada A, Samdani AF, Stephen JH, Bennett JT, Baaj AA, Hwang SW
Childs Nerv Syst 2018 Nov;34(11):2155-2171. Epub 2018 Aug 4 doi: 10.1007/s00381-018-3915-6. PMID: 30078055
Guyer RD, Ohnmeiss DD; NASS
Spine J 2003 May-Jun;3(3 Suppl):11S-27S. doi: 10.1016/s1529-9430(02)00563-6. PMID: 14589214

Therapy

Pahys JM, Guille JT
J Pediatr Orthop 2018 Mar;38(3):e172-e179. doi: 10.1097/BPO.0000000000000922. PMID: 28009797
Bambakidis NC, Feiz-Erfan I, Klopfenstein JD, Sonntag VK
Spine (Phila Pa 1976) 2005 Aug 15;30(16 Suppl):S2-6. doi: 10.1097/01.brs.0000174509.31291.26. PMID: 16103830
Guyer RD, Ohnmeiss DD; NASS
Spine J 2003 May-Jun;3(3 Suppl):11S-27S. doi: 10.1016/s1529-9430(02)00563-6. PMID: 14589214
Zdeblick TA, Phillips FM
Spine (Phila Pa 1976) 2003 Aug 1;28(15 Suppl):S2-7. doi: 10.1097/01.BRS.0000076841.93570.78. PMID: 12897467
Steinmann JC, Herkowitz HN
Clin Orthop Relat Res 1992 Nov;(284):80-90. PMID: 1395317

Prognosis

Rebello D, Wohler E, Erfani V, Li G, Aguilera AN, Santiago-Cornier A, Zhao S, Hwang SW, Steiner RD, Zhang TJ, Gurnett CA, Raggio C, Wu N, Sobreira N, Giampietro PF, Ciruna B
Hum Mol Genet 2023 Sep 16;32(19):2913-2928. doi: 10.1093/hmg/ddad117. PMID: 37462524Free PMC Article
Huang PJ, Lin JH, Chiang YH
World Neurosurg 2020 Jun;138:e634-e641. Epub 2020 Mar 13 doi: 10.1016/j.wneu.2020.03.023. PMID: 32173550
Frikha R
Clin Dysmorphol 2020 Jan;29(1):35-37. doi: 10.1097/MCD.0000000000000301. PMID: 31577545
Klekamp J
Eur Spine J 2014 Aug;23(8):1656-65. Epub 2014 Jun 18 doi: 10.1007/s00586-014-3423-7. PMID: 24938181
Steinmann JC, Herkowitz HN
Clin Orthop Relat Res 1992 Nov;(284):80-90. PMID: 1395317

Clinical prediction guides

Rebello D, Wohler E, Erfani V, Li G, Aguilera AN, Santiago-Cornier A, Zhao S, Hwang SW, Steiner RD, Zhang TJ, Gurnett CA, Raggio C, Wu N, Sobreira N, Giampietro PF, Ciruna B
Hum Mol Genet 2023 Sep 16;32(19):2913-2928. doi: 10.1093/hmg/ddad117. PMID: 37462524Free PMC Article
Lee CY, Wu CL, Chang HK, Wu JC, Huang WC, Cheng H, Tu TH
Clin Neurol Neurosurg 2021 Oct;209:106934. Epub 2021 Sep 3 doi: 10.1016/j.clineuro.2021.106934. PMID: 34543827
Litrenta J, Bi AS, Dryer JW
J Am Acad Orthop Surg 2021 Nov 15;29(22):951-960. doi: 10.5435/JAAOS-D-21-00190. PMID: 34288888
Klekamp J
Eur Spine J 2014 Aug;23(8):1656-65. Epub 2014 Jun 18 doi: 10.1007/s00586-014-3423-7. PMID: 24938181
Arlet V, Odent T, Aebi M
Eur Spine J 2003 Oct;12(5):456-63. Epub 2003 Jun 14 doi: 10.1007/s00586-003-0555-6. PMID: 14618384Free PMC Article

Recent systematic reviews

De Marco R, Nasto LA, Strangio A, Piatelli G, Pavanello M
Childs Nerv Syst 2024 May;40(5):1541-1569. Epub 2024 Mar 9 doi: 10.1007/s00381-024-06341-8. PMID: 38459148
Portella ST, Acioly MA
J Clin Neurosci 2017 Jul;41:6-10. Epub 2017 Apr 19 doi: 10.1016/j.jocn.2017.04.007. PMID: 28431955

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