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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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Improvement of dropped head deformity and total spinal alignment.
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Figure 2: Improvement of dropped head deformity and total spinal alignment.

Mentions: Postoperatively, the patient exhibited improvement of head positioning while standing and walking, without neck pain. Plain lateral radiography in standing position 4 months after surgery revealed improvement of sagittal balance and pelvic tilt compared to preoperative results (preoperative C7 plumb line -85.1 mm → postoperative C7 plumbline -11.7 mm, preoperative pelvic tilt 22° → postoperative pelvic tilt 14°), with significant improvement in overall spinal alignment (Figures 1, 2). The patient reported a dramatic improvement in his quality of life, enabling him to perform the daily activities of eating, reading, standing and walking without difficulty.


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)

Improvement of dropped head deformity and total spinal alignment.
© Copyright Policy - open-access
Related In: Results  -  Collection

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

Figure 2: Improvement of dropped head deformity and total spinal alignment.
Mentions: Postoperatively, the patient exhibited improvement of head positioning while standing and walking, without neck pain. Plain lateral radiography in standing position 4 months after surgery revealed improvement of sagittal balance and pelvic tilt compared to preoperative results (preoperative C7 plumb line -85.1 mm → postoperative C7 plumbline -11.7 mm, preoperative pelvic tilt 22° → postoperative pelvic tilt 14°), with significant improvement in overall spinal alignment (Figures 1, 2). The patient reported a dramatic improvement in his quality of life, enabling him to perform the daily activities of eating, reading, standing and walking without difficulty.

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