This document summarizes a case of spastic quadriparesis in an 18-year-old male. Imaging revealed complex craniovertebral junction anomalies including basilar invagination, platybasia, os odontoideum, and atlantoaxial subluxation causing spinal cord compression. The patient was diagnosed with Klippel-Feil syndrome based on clinical features including short stature, low hairline, and restricted neck movement. Treatment options discussed include medical management, traction, and posterior fusion surgery to stabilize and decompress the craniocervical junction.