Short neck in a newborn: a disease or physiological problem that can be corrected

Diagnostics

Accordingly, various causes and consequences make it necessary to carefully examine the baby. How to understand what is wrong with a baby? Only an x-ray will give a definite answer. However, experienced doctors are able to guess, even without radiation, what the true cause of the syndrome is.

Signs of Klippel-Feil disease:

• limited head mobility;
• low hairline;
• the shoulder blades are at different levels, but generally abnormally high;
• curvature of the spine may be noted.

As a rule, with this syndrome, the newborn also suffers from other pathologies: anomalies in the formation of internal organs often develop.

Birth trauma sometimes manifests itself with similar symptoms, but most often it also has other signs:

1. the child sleeps poorly and is capricious;
2. neck muscles are overly tense;
3. touching the neck area causes the child to cry, since straightening this section causes him pain;
4. head mobility is also limited.

Understanding how short the neck really is will be achieved by a simple exercise: place the baby on his stomach and lift him up to determine the location of the hairline. It should be approximately 3 cm from the shoulders. Be sure to count the vertebrae. Let us remind you that there should be 7 of them in the cervical region.

Therapeutic therapy for the syndrome

As a rule, treatment for a short neck in an infant comes down to the need to wear a device such as a Shants collar, as well as to the prescription of physiotherapy and exercise therapy. It is the complex of these methods that leads to rapid normalization of the situation. As already mentioned, already a year after treatment was prescribed, parents and the baby completely forget about the problem.

Shantsa tire

A special orthopedic collar, thanks to which the child’s neck returns to normal, is a soft but dense bandage. It fixes the cervical spine, thereby relieving the load from it, and in addition, such a collar eliminates the spasm of the muscles that compress the arteries, as a result of which the blood supply to the brain is also restored. Externally, such a collar looks like a circle of foam rubber with Velcro, no more than 5 cm high.

Depending on the complexity of the situation, this collar can be worn immediately after the baby is born or for 2-3 months. They wear it every day, without taking it off, in case of severe manifestations of the syndrome in infants, or only 20-30 minutes a day if the neck is not significantly curved. If parents are tormented by the question of which collar is best to buy, then the answer is clear: you need to order an individual collar that takes into account all the physiological features of the baby.

Procedures

No less important in treatment are exercise therapy and massage. Such procedures must be performed by a specialist and it is better not to try to massage the baby yourself, since inept movements can only worsen the situation. However, proper massage helps relax tense muscles, thereby helping the Shants splint work. Massage and exercise therapy, as a rule, are complemented by warming procedures with paraffin and electrophoresis, which are also carried out by doctors in the clinic. It is the combination of these methods that leads to an improvement in the condition of the baby’s neck and to the disappearance of signs of pathology.

Danger of pathology

If Klippel-Feil syndrome undoubtedly forces parents to look for treatment methods, then birth trauma usually raises questions: does it need to be treated, maybe everything will go away on its own. But it should be understood that the neck is the place where the most important blood vessels pass, the quality of which determines the nutrition of the brain, its saturation with oxygen and other substances. As a result of compression of the arteries, blood circulation and brain development are disrupted, which leads to pathologies of a different nature. At the same time, the brain suffers from a lack of oxygen, and hypoxia, as is known, can lead to the onset of irreversible processes in the body.

Babies diagnosed with short neck syndrome understand early what headaches are. Their vision declines, vegetative-vascular dystonia and scoliosis develop.

Klippel-Feil syndrome

Klippel-Feil syndrome - (short neck syndrome; Klippel-Feil syndrome) is a congenital malformation of the cervical and upper thoracic vertebrae, which is characterized by deformation (shortening) of the neck caused by a decrease in the number of cervical vertebrae, their fusion or smaller size. Population frequency 1: 120,000.

There are three types of deformation:

1. reduction in the total number of cervical vertebrae;
2. synostosis (fusion) of the entire cervical spine fused into a single bone with the occipital bone and upper thoracic vertebrae;
3. a combination of type 1 or 2 with synostosis of the lower thoracic and lumbar vertebrae.

Klippel-Feil syndrome is characterized by a triad of symptoms:

• short neck,
• low hairline on the neck,
• limitation of head mobility.

Klippel-Feil syndrome is often combined with other developmental anomalies. Thus, in 25-30% of patients, scoliosis, pterygoid folds of the neck, rigid bone form of torticollis, high scapula - Sprengel's disease are determined. Developmental anomalies of the upper and lower extremities are detected. 35% of patients have severe renal developmental anomalies. Anomalies in the development of the cardiovascular system are quite common. Disturbances in the development of the spinal column are accompanied by disturbances in the development of the nervous system.

The syndrome is genetically heterogeneous (Table 1); sporadic cases also occur.

Table 1. Types of Klippel-Feil syndrome (genes are highlighted in blue, the analysis of which is carried out at the Center for Molecular Genetics).

GDF6 gene encodes a protein belonging to the TGFα (transforming growth factor beta) superfamily, which is a group of proteins that control the growth and development of tissues throughout the body. GDF6 protein is necessary for the formation of bones and joints of the limbs, skull, spine, chest and ribs. The protein is involved in creating boundaries between bones during skeletal development. Mutations in this gene lead to KFS1 (Klippel-Feil syndrome type 1), coloboma (congenital anomalies in eye development) and isolated microphthalmia type 5. The gene is located on chromosome 8, at the 8q22.1 locus, and consists of two exons.

At the Center for Molecular Genetics, direct diagnosis of Klippel-Feil syndrome is carried out by direct sequencing of the coding region of the GDF6 gene.

Klippel-Feil syndrome

Treatment options

The main methods of treatment are physiotherapy, therapeutic exercises and special devices for stretching muscles and vertebrae.

Shants collar

Choosing this collar is convenient because it is worn during normal times when the child is awake or walking. An orthopedic splint is usually an addition to other measures.

The impact of the collar is determined by the fact that it relieves tension, fixing the spine in a normal state. This relieves muscle spasm, frees arteries and improves blood circulation and nutrition to the brain. A timely prescribed splint eliminates pathological changes in the development of the baby.

It is important to choose the optimal size collar that will not put pressure or hang around the baby’s neck. Wear it for a limited time:

• for mild forms – 10-20 minutes several times a day;
• in a difficult situation, the baby is forced to wear a splint almost all day.

Physiotherapy and gymnastics

Proper gymnastics to improve blood circulation will not be superfluous for a healthy child, especially since it is necessary for a baby with short neck syndrome. Massage, exercise therapy, physiotherapy - all this allows you to relax the muscles, allowing you to increase the effectiveness of other measures.

Using electrophoresis, you can increase the effectiveness of treatment with medications, which in the form of ions reach their destination through the skin.

Paraffin heating can also be used. They can also be made at home, but to do this you need to have skills or at least an understanding of the process: first prepare an oilcloth of the desired shape. It is heated in the oven, and the paraffin is heated in a water bath to pour onto the “patterns” of the neck-collar area. It is important that the substance is warm, but in no case hot. After the blanks are applied to the problem area, the child is wrapped in a warm cloth or blanket. You need to keep the paraffin for 30 to 60 minutes. After such a procedure, be sure to lubricate the baby’s skin with cream, and then put on a Shants collar.

Klippel-Feil syndrome

This syndrome, alas, cannot be treated by the listed methods: surgical intervention is necessary to eliminate it. During the operation, the compacted vertebrae are first fixed with special metal devices. When there are not enough vertebrae, artificial elements are inserted instead. If some of them have grown together, they are separated and, if necessary, implants are inserted.

After the operation, treatment follows the scheme described above - with a Shants collar, gymnastics, massages and physiotherapy.

As a rule, with proper and timely treatment, short neck syndrome goes away in 2-3 months. It is important to start the procedures on time, since every month it is already quite difficult to force the baby to lie with the same paraffin, and both the muscles and vertebrae can transform. This leads to irreversible consequences and problems in the development of the baby.

Treatment of congenital spinal defects in Israel - techniques

Congenital anomalies of the spine include various spinal deformities, vertebral defects, etc. Most often, specialists at our clinic encounter such anomalies as lumbarization and sacralization, wedge-shaped vertebrae, short neck syndrome, vertebral bifida, and congenital spinal stenosis.

Lumbarization of the spine

The lumbar (lumbar) spine consists of 5 vertebrae and connects to the sacrum. If the first vertebra is not connected to the sacrum, the patient is diagnosed with spinal lumbarization. This pathology of intrauterine development leads to chronic pain syndrome and limited mobility in the back. If the patient’s symptoms are severe, prolotherapy (proliferation therapy) is recommended - a procedure in which an irritating substance (dextrose, phenolic compounds, lidocaine, glycerin, etc.) is injected into the area where the anomaly is localized using a syringe, which causes local inflammation. This provokes the growth of new connective tissue and leads to improved fixation of the vertebrae. Typically, prolotherapy includes 3-6 procedures, each of which is performed once every 2-3 weeks.

Also, lumbarization can be treated by a surgical operation, during which vertebrae with excessive mobility are fixed using spinal fusion methods (attached to adjacent vertebrae with metal bridges and screws or using bone cement).

Sacralization of the spine

Sacralization of the spine is a pathological fusion of the first lumbar vertebra with the sacrum. Fusion can be bilateral or unilateral and, like lumbarization, can cause chronic pain and limit the patient’s mobility. If symptoms are mild, physiotherapy is performed and anti-inflammatory drugs are prescribed. If conservative treatment methods do not help, surgery is performed to remove the sacralized transverse process of the vertebra, followed by spinal fusion or without it.

Sphenoid vertebra

Sphenoid vertebra is a very common congenital spinal anomaly. A wedge-shaped vertebra (hemivertebra) anatomically consists of a semi-arch and a semi-body. Often such hemivertebrae cause the development of scoliosis, kyphosis or lordosis, narrowing of the spinal canal, instability of the spine and even fractures.

Treatment for this anomaly is surgical and consists of resection of the hemivertebra followed by spinal fusion (fixation of the spinal sections located above and below the removed hemivertebra). Often after such an operation the patient is prescribed to wear a corset for a certain period of time.

Short neck syndrome

Short neck syndrome (Klippel-Feil syndrome) occurs as a result of synostosis - pathological fusion of the vertebrae or due to a decrease in the number of cervical vertebrae. This syndrome is treated surgically, using various methods of arthroplasty and spinal fusion. In the same way, a complete disc replacement can be performed, which can reduce pain or eliminate pain altogether. Spinal fusion is used to correct the curvature of the cervical spine associated with the disease.

Spina bifida

Spina bifida is a pathological congenital cleft of one of the vertebrae. This leads to incomplete closure of the spinal cord membranes and a variety of neurological disorders. Treatment of this disease requires an integrated approach, the participation of various specialists - from neurosurgeons to urologists. The main tasks are closing the defect and correcting vertebral deformities. Often, surgery to close a patent vertebra is combined with spinal fusion. Many patients with spina bifida suffer from comorbidities, the most common of which is hydrocephalus. Treatment of hydrocephalus in our clinic can be carried out in parallel with the main therapy.

Spinal stenosis

In some cases, spinal stenosis may also be a congenital pathology. This anomaly is treated using several surgical techniques, the main of which is decompression laminectomy. It involves removing the vertebral arch, which puts pressure on the spinal cord and nerve roots. After surgery, instability of the spine may occur, so it is often combined with the installation of anterior or posterior stabilization systems, as well as interspinous fixation systems (various types of implants that help restore the stability of the supporting column of the spine).

• Endoscopic spinal correction