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Dropped head syndrome due to myogenic atrophy - a case report of surgical treatment.

Zenmyo M, Abematsu M, Yamamoto T, Ishidou Y, Komiya S, Ijiri K - Diagn Pathol (2011)

Bottom Line: Over a period of 2 years, he exhibited progressive inability to lift his chin off his chest, resulting in the dropped head position that impaired his activities of daily living.Anterior combined posterior reconstruction surgery yielded a successful outcome in his activities of daily living, including his walking balance of spinal alignment.Pathologic study confirmed myogenic atrophy in the cervical extensor muscles.

View Article: PubMed Central - HTML - PubMed

Affiliation: Orthopaedic Surgery, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan.

ABSTRACT
We report a case of a 69-year-old man with dropped head syndrome associated with isolated neck extensor myopathy (INEM). Over a period of 2 years, he exhibited progressive inability to lift his chin off his chest, resulting in the dropped head position that impaired his activities of daily living. He had a disturbed gait with severe imbalance of spinal alignment. Computed tomography revealed osseous contracture of cervical vertebral bodies in flexed position. Anterior combined posterior reconstruction surgery yielded a successful outcome in his activities of daily living, including his walking balance of spinal alignment. Pathologic study confirmed myogenic atrophy in the cervical extensor muscles. We suggest that consideration for surgical management should be given to dropped head syndrome especially due to INEM.

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Dropped head deformity before surgery. Radiographs showing degenerative kyphoscoliosis with ossification of the anterior longitudinal ligament. Impairment in total spinal alignment due to cervical kyphosis.
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Figure 1: Dropped head deformity before surgery. Radiographs showing degenerative kyphoscoliosis with ossification of the anterior longitudinal ligament. Impairment in total spinal alignment due to cervical kyphosis.

Mentions: Over a period of 2 years, a previously healthy 69-year-old man exhibited progressive inability to lift his chin off his chest. The dropped head position severely impaired his activities of daily living. When he visited our institution, he complained of severe neck pain without neurological abnormalities such as motor weakness or sensory disturbance. He had no family history of DHS. No systemic risk factors, such as diabetes, vascular disorders, history of smoking, were reported. He was working as an office worker for 25 years, without potential professional hazard for DHS. A plain radiograph revealed cervical degenerative kyphoscoliosis with ossification of the anterior longitudinal ligament (Figure 1). Electrodiagnostic study demonstrated polyphasic motor unit potentials (MUP) but no fibrillation potentials in the trapezius muscle. Both the amplitude and duration of voluntary MUP of the trapezius muscle was normal. Resting MUP was not detected due to continuous fibrillation in the splenius capitus muscle. All laboratory findings including creatine kinase level were normal.


Dropped head syndrome due to myogenic atrophy - a case report of surgical treatment.

Zenmyo M, Abematsu M, Yamamoto T, Ishidou Y, Komiya S, Ijiri K - Diagn Pathol (2011)

Dropped head deformity before surgery. Radiographs showing degenerative kyphoscoliosis with ossification of the anterior longitudinal ligament. Impairment in total spinal alignment due to cervical kyphosis.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3037290&req=5

Figure 1: Dropped head deformity before surgery. Radiographs showing degenerative kyphoscoliosis with ossification of the anterior longitudinal ligament. Impairment in total spinal alignment due to cervical kyphosis.
Mentions: Over a period of 2 years, a previously healthy 69-year-old man exhibited progressive inability to lift his chin off his chest. The dropped head position severely impaired his activities of daily living. When he visited our institution, he complained of severe neck pain without neurological abnormalities such as motor weakness or sensory disturbance. He had no family history of DHS. No systemic risk factors, such as diabetes, vascular disorders, history of smoking, were reported. He was working as an office worker for 25 years, without potential professional hazard for DHS. A plain radiograph revealed cervical degenerative kyphoscoliosis with ossification of the anterior longitudinal ligament (Figure 1). Electrodiagnostic study demonstrated polyphasic motor unit potentials (MUP) but no fibrillation potentials in the trapezius muscle. Both the amplitude and duration of voluntary MUP of the trapezius muscle was normal. Resting MUP was not detected due to continuous fibrillation in the splenius capitus muscle. All laboratory findings including creatine kinase level were normal.

Bottom Line: Over a period of 2 years, he exhibited progressive inability to lift his chin off his chest, resulting in the dropped head position that impaired his activities of daily living.Anterior combined posterior reconstruction surgery yielded a successful outcome in his activities of daily living, including his walking balance of spinal alignment.Pathologic study confirmed myogenic atrophy in the cervical extensor muscles.

View Article: PubMed Central - HTML - PubMed

Affiliation: Orthopaedic Surgery, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan.

ABSTRACT
We report a case of a 69-year-old man with dropped head syndrome associated with isolated neck extensor myopathy (INEM). Over a period of 2 years, he exhibited progressive inability to lift his chin off his chest, resulting in the dropped head position that impaired his activities of daily living. He had a disturbed gait with severe imbalance of spinal alignment. Computed tomography revealed osseous contracture of cervical vertebral bodies in flexed position. Anterior combined posterior reconstruction surgery yielded a successful outcome in his activities of daily living, including his walking balance of spinal alignment. Pathologic study confirmed myogenic atrophy in the cervical extensor muscles. We suggest that consideration for surgical management should be given to dropped head syndrome especially due to INEM.

Show MeSH
Related in: MedlinePlus