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Sergeenko OM, Evsyukov AV, Filatov EY, Ryabykh SO, Burtsev AV, Gubin AV. Cervicothoracic dislocation due to congenital and bone-dysplasia-related vertebral malformations. Spine Deform 2023; 11:1223-1238. [PMID: 37086364 DOI: 10.1007/s43390-023-00690-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Accepted: 04/08/2023] [Indexed: 04/23/2023]
Abstract
PURPOSE To evaluate the approaches to treatment of congenital and bone-dysplasia-related pediatric cervicothoracic dislocations and define the optimal treatment method. METHODS The publications available in PubMed and Google Scholar data bases were selected following such criteria as the disease in question, pediatric age, the treatment description, and follow-up results. The paper also includes the descriptions of our own six cases of the cervicothoracic dislocations detected in children with different vertebral malformations. RESULTS Only eight patients meeting the abovementioned selection criteria were found in the publications: three of them had the Klippel-Feil syndrome (KFS), two had one-level vertebral anomaly, one had neurofibromatosis (NF type 1), one had the Larsen syndrome, and one had a variation of VACTERL association. Their treatment was long term, multi stage, and complicated. Among six our own cases, four patients also had KFS, one had a variation of VACTERL association, and one had NF type 1. All the patients suffered from preoperative neurological disorders. Posterior instrumental fixation with posterior vertebral body resection was performed in four cases and one patient underwent a combined surgery. The parents of one of the patients refused the operation, so he was observed while receiving bracing treatment. Since the treatment was long term and complicated by reoperations, the average follow-up period comprised 5 years. CONCLUSION Congenital cervicothoracic dislocations are an extremely rare pathology that manifests itself in early age and requires an early surgical treatment. Failure to provide the treatment leads to the patient's disability. The surgical tactics for such patients is determined individually, but the published data and our own experience demonstrate that early multi-stage combined treatment has been the best option available so far. The cervicothoracic dislocations due to NF 1 manifest later and have a more favorable forecast.
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Arsicot M, Bordet M. Think About Klippel-Feil as Causing Neurogenic Thoracic Outlet Syndrome! Eur J Vasc Endovasc Surg 2023; 65:502. [PMID: 36574924 DOI: 10.1016/j.ejvs.2022.12.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Revised: 11/28/2022] [Accepted: 12/19/2022] [Indexed: 12/25/2022]
Affiliation(s)
- Matthieu Arsicot
- Service de Chirurgie Vasculaire et Endovasculaire, Hospices Civils de Lyon, France.
| | - Marine Bordet
- Service de Chirurgie Vasculaire et Endovasculaire, Hospices Civils de Lyon, France; Claude Bernard Lyon 1 University, Lyon, France
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Hu B, Zhou H, Zou X. Letter to the editor concerning "Demographics, presentation and symptoms of patients with Klippel-Feil syndrome: analysis of a global patient-reported registry" by Nouri et al. [Eur Spine J; (2019) 28(10): 2257-2265]. Eur Spine J 2019; 29:384. [PMID: 31773276 DOI: 10.1007/s00586-019-06228-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/10/2019] [Revised: 10/10/2019] [Accepted: 11/17/2019] [Indexed: 11/26/2022]
Affiliation(s)
- Bailong Hu
- Department of Anesthesiology, The Affiliated Hospital of Guizhou Medical University, No. 28 Guiyi Street, Yunyan District, 550004, Guiyang, China.
| | - Haiyan Zhou
- Department of Clinical Research Centre, The Affiliated Hospital of Guizhou Medical University, No. 28 Guiyi Street, Yunyan District, 550004, Guiyang, China
| | - Xiaohua Zou
- Department of Anesthesiology, The Affiliated Hospital of Guizhou Medical University, No. 28 Guiyi Street, Yunyan District, 550004, Guiyang, China.
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Pacreu S, Martínez S, Vilà E, Moltó L, Fernández-Candil J. Dexmedetomidine in difficult airway management with a fibre-optic bronchoscope in the awake patient with Klippel-Feil Syndrome. Rev Esp Anestesiol Reanim (Engl Ed) 2018; 65:537-540. [PMID: 29887292 DOI: 10.1016/j.redar.2018.05.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/22/2018] [Revised: 05/04/2018] [Accepted: 05/06/2018] [Indexed: 06/08/2023]
Abstract
Klippel-Feil Syndrome is a disease characterised by congenital fusion of cervical vertebra, which leads to cervical limitation and instability. In these cases, the best option is the orotracheal intubation with the fibre-optic bronchoscope with the patient awake. The advantage is that cervical movements that could lead to neurological damage are minimised. In these patients, adequate sedation, together with instillation of local anaesthetic in the pharynx and hypopharynx, is the key to reducing patient discomfort and achieving successful orotracheal intubation. Dexmedetomidine is a selective α2- adrenergic receptor agonist that produces sedation and analgesia at the locus coeruleus without producing respiratory depression, as well as maintaining patient collaboration. The case is presented of a patient with Klippel-Feil Syndrome and difficult airway management, who was given a dexmedetomidine infusion at 0.6μg/kg/h as sedation for an awake fibre-optic endotracheal intubation.
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Affiliation(s)
- S Pacreu
- Servicio de Anestesiología, Reanimación y Terapia del dolor, Parc de Salut Mar, Barcelona, España.
| | - S Martínez
- Servicio de Anestesiología, Reanimación y Terapia del Dolor, Hospital de la Santa Creu i Sant Pau, Barcelona, España
| | - E Vilà
- Servicio de Anestesiología, Reanimación y Terapia del dolor, Parc de Salut Mar, Barcelona, España
| | - L Moltó
- Servicio de Anestesiología, Reanimación y Terapia del dolor, Parc de Salut Mar, Barcelona, España
| | - J Fernández-Candil
- Servicio de Anestesiología, Reanimación y Terapia del dolor, Parc de Salut Mar, Barcelona, España
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Narang M, Goyal JP. Uncommon manifestations of Klippel Feil syndrome. Indian Pediatr 2006; 43:265-6. [PMID: 16585825] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/08/2023]
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Sehata H, Kohase H, Takahashi M, Miyamoto T, Umino M. Tracheal intubation using a new CCD camera-equipped device: a report of two cases with a difficult intubation. Acta Anaesthesiol Scand 2005; 49:1218-20. [PMID: 16095466 DOI: 10.1111/j.1399-6576.2005.00796.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
In two patients, one with Klippel-Feil syndrome and one with fibrous dysplasia of the maxilla, no part of the larynx could be visualized by direct laryngoscopy. In both cases, the use of an intubation device equipped with a charge-coupled device camera, the endotracheal intubation device (EID), allowed smooth tracheal intubation.
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Affiliation(s)
- H Sehata
- Anesthesiology and Clinical Physiology, Department of Oral Restitution, Division of Oral Sciences, Graduate School, Tokyo Medical and Dental University, Tokyo, Japan
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Iwasaki K. [ Klippel-Feil syndrome]. Ryoikibetsu Shokogun Shirizu 2002:49-50. [PMID: 11528856] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/21/2023]
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Imaizumi K. [Wildervanck (cervico-oculo-acoustic) syndrome]. Ryoikibetsu Shokogun Shirizu 2001:361-2. [PMID: 11462476] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/20/2023]
Affiliation(s)
- K Imaizumi
- Division of Medical Genetics, Kanagawa Children's Medical Center
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Matsuda M. [ Klippel-Feil syndrome]. Ryoikibetsu Shokogun Shirizu 2001:590-2. [PMID: 11043334] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/18/2023]
Affiliation(s)
- M Matsuda
- Department of Neurosurgery, Shiga University of Medical Science
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Smith JE. Intraoperative nasotracheal to orotracheal tube change in a patient with Klippel-Feil syndrome. Anaesth Intensive Care 1996; 24:120. [PMID: 8669635] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
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Shiozawa Z. [ Klippel-Feil syndrome]. Ryoikibetsu Shokogun Shirizu 1996:273-4. [PMID: 9048011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Affiliation(s)
- Z Shiozawa
- Third Department of Internal Medicine, Yamanashi Medical College
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Abstract
A 34-year-old woman with severe kyphoscoliosis, an immobile cervical spine, and short stature due to the Klippel-Feil syndrome presented for elective Caesarean section. She expressed a strong desire to remain awake during the procedure. We chose a technique using a spinal microcatheter to provide spinal anaesthesia on the basis that incremental control of the dose of bupivacaine would reduce the risk of 'high' block. Awake inspection of the larynx was performed as a precaution in the event of respiratory embarrassment. A total of 6.25 mg heavy bupivacaine, 7.5 mg plain bupivacaine, and 10 micrograms fentanyl were administered over 20 min. This provided anaesthesia up to T5 without significant effects on respiratory or cardiovascular function. The patient was successfully delivered of a healthy boy.
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Affiliation(s)
- M R Dresner
- Department of Anaesthesia, St James's University Hospital, Leeds
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Novella J. Intraoperative nasotracheal to orotracheal tube change in a patient with Klippel-Feil syndrome. Anaesth Intensive Care 1995; 23:402-3. [PMID: 7573935] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
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Keeney G, Gebarski SS, Brunberg JA. CT of severe inner ear anomalies, including aplasia, in a case of Wildervanck syndrome. AJNR Am J Neuroradiol 1992; 13:201-2. [PMID: 1595443 PMCID: PMC8331751] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Affiliation(s)
- G Keeney
- Department of Radiology, University of Michigan Hospitals, Ann Arbor 48109-0030
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Affiliation(s)
- L E Bolano
- Department of Orthopedic Surgery and Rehabilitation, University of Oklahoma Health Science Center, Oklahoma City
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Monterisi N, Tofani S, Testaferrata A, Corti G. [A case of Klippel-Feil syndrome associated with Sprengel's deformity and congenital cardiopathy]. Minerva Pediatr 1979; 31:297-301. [PMID: 460088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
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Gupta M, Singh RN. The Klipple Feil syndrome: (a case report). Indian Pediatr 1978; 15:437. [PMID: 700882] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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Chepulis SP, Gradauskas LK, Morkunas RM. [ Klippel-Feil syndrome as link to multiple dysplasias of the skeletal bones]. Stomatologiia (Mosk) 1976; 55:92-4. [PMID: 1063482] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
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Mündnich K. The dysplasias of the middle and the inner ear in different types of malformation. Proc R Soc Med 1974; 67:1197-8. [PMID: 4449857 PMCID: PMC1645879] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
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Pérez-Comas A, García-Castro JM. Occipito-facial-cervico-thoracic-abdomino-digital dysplasia; Jarcho-Levin syndrome of vertebral anomalies. Report of six cases and review of the literature. J Pediatr 1974; 85:388-91. [PMID: 4372555 DOI: 10.1016/s0022-3476(74)80126-5] [Citation(s) in RCA: 49] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
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Gukovich VA, Rozenfel'd LG. [Case of Klippel-Feil syndrome associated with ear abnormality]. Vestn Otorinolaringol 1974; 2:104-5. [PMID: 4832897] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
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Grinberg I. [On Franceschetti's mandibulofacial dysostosis]. Otorinolaringologie 1972; 17:355-60. [PMID: 4645449] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
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Talyzina NK. [Congenital hypotrophy in children]. Feldsher Akush 1972; 37:23-7. [PMID: 4484409] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
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Rassumowska D, Malinowski A. [Anthropomorphological characteristics of Klippel-Feil syndrome with cleft palate]. Czas Stomatol 1970; 23:1075-81. [PMID: 5272448] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
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Dikshit SK, Agarwal SP, Gupta RC, Singh RS. Klippel-Feil syndrome. Indian J Pediatr 1969; 36:245-7. [PMID: 5355321 DOI: 10.1007/bf02749334] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
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Heide M. [Cervical syndrome in roentgenologically demonstrable changes of the cervical spine]. Med Klin 1969; 64:391-4. [PMID: 5783027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
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Traunfellner Z. [A case of Klippel-Feil syndrome]. Wiad Lek 1968; 21:521-2. [PMID: 5651466] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
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Marini F. [The Klippel-Feil syndrome]. Fracastoro 1968; 61:200-5. [PMID: 5704052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
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Troy JJ. A case of Klippel-Feil syndrome. Ir J Med Sci 1968; 7:15-8. [PMID: 5641572 DOI: 10.1007/bf02946432] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
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[ Klippel-Feil syndrome]. Jibiinkoka 1967; 39:1307. [PMID: 5628552] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
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Jekić B, Pavićević R. [A case of Klippel-Feil syndrome]. SRP ARK CELOK LEK 1966; 94:937-42. [PMID: 5994150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
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Khatua SP. Klippel-Feil syndrome. Indian Pediatr 1965; 2:455-60. [PMID: 5861715] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
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ROSS RB, LINDSAY WK. THE CERVICAL VERTEBRAE AS A FACTOR IN ETIOLOGY OF CLEFT PALATE. Cleft Palate J 1965; 36:273-81. [PMID: 14310244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/26/2023]
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HAJDU E, KISS M, LISZKA G. [ KLIPPEL-FEIL SYNDROME WITH MULTIPLE DEVELOPMENTAL ANOMALIES]. Fortschr Geb Rontgenstr Nuklearmed 1965; 102:722-3. [PMID: 14308965] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/26/2023]
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BINTLIFF SJ. KLIPPEL-FEIL SYNDROME. J Am Med Womens Assoc 1965; 20:547-50. [PMID: 14296906] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/26/2023]
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JAIN AC, SINGH SD, THAKAR SV, RANAWAT CS. KLIPPEL FEIL SYNDROME. A BRIEF REVIEW WITH REPORT OF 7 CASES. Indian J Med Sci 1965; 19:189-93. [PMID: 14291035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/26/2023]
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