{"id":"34f639de-acab-4158-ad0b-5922e059c350","slug":"surgical-management-of-dropped-head-syndrome-a-systematic-review","title":"Surgical management of dropped head syndrome: A systematic review","authors":["María José Cavagnaro","José Manuel Orenday-Barraza","Amna Hussein","Mauricio J. Avila","Dara Farhadi","Angelica Alvarez Reyes","Isabel L. Bauer","Naushaba Khan","Ali A. Baaj"],"abstract":"Background: Dropped head syndrome (DHS) is uncommon and involves severe weakness of neck-extensor muscles resulting in a progressive reducible cervical kyphosis. The first-line management consists of medical treatment targeted at diagnosing underlying pathologies. However, the surgical management of DHS has not been well studied. Methods: Here, we systematically reviewed the PubMed and Cochrane databases for DHS using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. All relevant articles up to March 31, 2022, were analyzed. The patient had to be ≥18 years with DHS and had to have undergone surgery with outcomes data available. Outcomes measurements included neurological status, rate of failure (RF), horizontal gaze, and complications. Results: A total of 22 articles selected for this study identified 54 patients who averaged 68.9 years of age. Cervical arthrodesis without thoracic extension was performed in seven patients with a RF of 71%. Cervicothoracic arthrodesis was performed in 46 patients with an RF of 13%. The most chosen upper level of fusion was C2 in 63% of cases, and the occiput was included only in 13% of patients. All patients neurologically stabilized or improved, while 75% of undergoing anterior procedures exhibited postoperative dysphagia and/or airway-related complications. Conclusion: The early surgery for patients with DHS who demonstrate neurological compromise or progressive deformity is safe and effective and leads to excellent outcomes.","thumbnailUrl":"https://sni-digital-videos.s3.amazonaws.com/articles/34f639de-acab-4158-ad0b-5922e059c350/featured/hero-1781561262958.png","publishDate":"2022-06-17T00:00:00.000Z","doi":"10.25259/SNI_456_2022","categories":["Spine","Review Article"],"fullTextUrl":"https://surgicalneurologyint.com/wp-content/uploads/2022/06/11658/SNI-13-255.pdf"}