- Department of Neurosurgery, Otsu City Hospital, Otsu, Shiga, Japan,
- Department of Neurosurgery, Biwako Ohashi Hospital, Otsu, Shiga, Japan.
Motohiro Takayama, Department of Neurosurgery, Otsu City Hospital, Otsu, Shiga, Japan.
DOI:10.25259/SNI_1228_2021Copyright: © 2022 Surgical Neurology International This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-Share Alike 4.0 License, which allows others to remix, transform, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms.
How to cite this article: Motohiro Takayama1, Yoshinori Maki2. Management of two patients with dropped head syndrome utilizing anterior-posterior cervical surgery. 18-Feb-2022;13:56
How to cite this URL: Motohiro Takayama1, Yoshinori Maki2. Management of two patients with dropped head syndrome utilizing anterior-posterior cervical surgery. 18-Feb-2022;13:56. Available from: https://surgicalneurologyint.com/surgicalint-articles/11403/
Background: Two elderly patients with dropped head syndromes (DHS) were successfully treated with circumferential cervical surgery.
Case Description: The two patients, respectively, 72 and 53 years of age, both underwent two-staged surgical procedures. The first surgery included the posterior placement of bilateral pedicle screws with multilevel facetectomies, followed by multilevel anterior cervical discectomy/fusion and posterior rod fixation.
Conclusion: Circumferential decompression/fusion successfully addressed chin on chest deformity in two older patients.
Keywords: Anterior fixation, Dropped head syndrome, Laminoplasty, Posterior fixation, Surgery
Dropped head syndrome (DHS) is a chin-on-chest deformity attributed to a noninflammatory myopathy of the cervical paraspinal muscles resulting in weakness of the cervical extensor musculature.[
A 72-year-old female presented with a progressive DHS syndrome and mild myelopathy (i.e., bilateral C5-C7 hyperreflexia). X-rays showed DHS, while the magnetic resonance images documented posterior compression at C-2 to C-3, and stenosis from C-5 to C-7 [
A 53-year-old male presented without myelopathy. Preoperative X-rays demonstrated DHS, while the MR showed C-5 to C-6 cord compression [
DHS can be classified into three groups based on preoperative radiological parameters; Type 1 (SVA ≤0 mm and PI-LL ≤10°), Type 2 (SVA > 0 mm and PI-LL ≤10°), and Type 3 (PI-LL >10°).[
Here, we corrected the DHS syndrome in two older patients utilizing a combined circumferential 360 degree decompression/fusion.
The authors certify that they have obtained all appropriate patient consent.
There are no conflicts of interest.
We would like to thank Dr. Ryota Ishibashi for his support of this study.
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