Cervical spinal cord neurapraxia in the setting of Klippel-Feil anomaly: A diagnostic and therapeutic challenge

Study design: Case report. Setting: Temple University Children's Medical Center in USA. Objectives: To report a patient whose recurrent and transient episodes of quadriplegia mimicked cervical cord neurapraxia. Cervical spine neuroimaging revealed congenital intersegmental fusion of C5 through C7 (consistent with Klippel-Feil anomaly), corresponding abnormal spinal cord signals on T2-weighted images and enhancing focal lesion opposite the C4 vertebral body. A posterior cervical decompression at C4-C5 and lateral mass fixation was performed, and the episodic quadriplegia has not recurred. Conclusion: Understanding of the biomechanics of Klippel-Feil anomaly may facilitate prompt referral for surgical management and avoidance of permanent disability.