Chiropractic Management of a Patient with Klippel-Feil Syndrome
More than 50% of patients with Klippel-Feil syndrome suffer from webbed neck, low hairline, and limited cervical range of motion (ROM). Numerous other congenital abnormalities often accompany these changes, including various cervical spine fusions and arthritic changes.
Because flexion-distraction manipulation is commonly utilized by doctors of chiropractic in managing lumbar spine conditions, the authors of the current study suggest its potential applicability in managing patients with Klippel-Feil syndrome. This case study documented how a patient with Klippel-Feil syndrome was managed using modified flexion distraction technique. A 34-year-old female presented to a chiropractic office with severe, unremitting cervical, shoulder and arm pain of several months' duration. Past medical history, clinical evaluation, and plain-film radiographs revealed findings consistent with Klippel-Feil syndrome (an anatomical entity that results in premature cervical degenerative changes, which may cause radiculopathy). The radiographs revealed a C2/3 block vertebrae, atlas assimilation, and premature degenerative findings.
Flexion-distraction manipulation and adjunctive therapies were applied to the patient. A cervical distraction instrument was utilized to apply flexion, with the practitioner’s contact hand at the T1/T2 level. Flexion was applied in sets of five, with five 4-second repetitions per set. Adjunctive physiotherapy in the form of hot moist packs and low-volt galvanic stimulation was applied prior to manipulation. The patient felt relief after the first treatment and experienced a complete resolution of her symptoms after eight treatments performed over a period of two years.
Conclusion: The authors suggest that due to the quick resolution of the patient's complaints, flexion-distraction may be a beneficial treatment option when managing patients with various types of cervical radiculopathy.
Kruse R, Schliesser J, DeBono V. Klippel-Feil syndrome with radioculopathy. Chiropractic management utilizing flexion-distraction technique: a case report. Journal of the Neuromusculoskeletal System 2000:8(4), pp. 124-131.
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