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Surgical treatment for dropped head syndrome with cervical spondylotic amyotrophy: a case report

BACKGROUND: Dropped head syndrome (DHS) is a flexion deformity of the neck that is caused by severe weakness of the neck extensor muscles. DHS occurs in combination with not only neuromuscular disorders, but also cervical spondylosis. However, there are few reports of DHS complicated by cervical spo...

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Autores principales: Taniguchi, Shinji, Takahashi, Hiroshi, Aoki, Yasuchika, Nakajima, Arata, Terajima, Fumiaki, Sonobe, Masato, Akatsu, Yorikazu, Yamada, Manabu, Furuya, Takeo, Koda, Masao, Yamazaki, Masashi, Ohtori, Seiji, Nakagawa, Koichi
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6057102/
https://www.ncbi.nlm.nih.gov/pubmed/30041689
http://dx.doi.org/10.1186/s13104-018-3612-2
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author Taniguchi, Shinji
Takahashi, Hiroshi
Aoki, Yasuchika
Nakajima, Arata
Terajima, Fumiaki
Sonobe, Masato
Akatsu, Yorikazu
Yamada, Manabu
Furuya, Takeo
Koda, Masao
Yamazaki, Masashi
Ohtori, Seiji
Nakagawa, Koichi
author_facet Taniguchi, Shinji
Takahashi, Hiroshi
Aoki, Yasuchika
Nakajima, Arata
Terajima, Fumiaki
Sonobe, Masato
Akatsu, Yorikazu
Yamada, Manabu
Furuya, Takeo
Koda, Masao
Yamazaki, Masashi
Ohtori, Seiji
Nakagawa, Koichi
author_sort Taniguchi, Shinji
collection PubMed
description BACKGROUND: Dropped head syndrome (DHS) is a flexion deformity of the neck that is caused by severe weakness of the neck extensor muscles. DHS occurs in combination with not only neuromuscular disorders, but also cervical spondylosis. However, there are few reports of DHS complicated by cervical spondylotic amyotrophy (CSA). Here we report a case of DHS with CSA in a patient who underwent surgical treatment. CASE PRESENTATION: A 79-year-old man became aware of dropped head and gait disturbance in addition to the paralysis of his right upper extremity. At his initial visit, he had a severe chin-on-chest posture. Neurological examination revealed severe paralysis of deltoid, biceps, wrist extensor, finger flexor, extensor, and abductors, in addition to lower extremity spasticity. Nevertheless, sensory dysfunction was not observed. X-ray images showed severe kyphosis at the upper thoracic level. MRI and CT myelography findings revealed spinal canal stenosis at the level of C5–6 and C6 root compression of the right side. Motor neuron disease was excluded because of findings from electromyography. Therefore, we diagnosed this patient as having DHS with cervical spondylotic amyotrophy. A C2–Th5 posterior fusion with C3–C6 laminoplasty and C5–6 foraminotomy on the right side were performed. After surgery, the complaint of dropped head was improved significantly and bilaterally finger motion was improved slightly. His neck position was maintained at the final follow-up at about 1 year after surgery. CONCLUSIONS: Despite the limitation of short-term follow-up, favorable results for the DHS were maintained in the present case. Surgical treatment for similar cases may be a feasible option, but surgery does have some complications.
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spelling pubmed-60571022018-07-30 Surgical treatment for dropped head syndrome with cervical spondylotic amyotrophy: a case report Taniguchi, Shinji Takahashi, Hiroshi Aoki, Yasuchika Nakajima, Arata Terajima, Fumiaki Sonobe, Masato Akatsu, Yorikazu Yamada, Manabu Furuya, Takeo Koda, Masao Yamazaki, Masashi Ohtori, Seiji Nakagawa, Koichi BMC Res Notes Case Report BACKGROUND: Dropped head syndrome (DHS) is a flexion deformity of the neck that is caused by severe weakness of the neck extensor muscles. DHS occurs in combination with not only neuromuscular disorders, but also cervical spondylosis. However, there are few reports of DHS complicated by cervical spondylotic amyotrophy (CSA). Here we report a case of DHS with CSA in a patient who underwent surgical treatment. CASE PRESENTATION: A 79-year-old man became aware of dropped head and gait disturbance in addition to the paralysis of his right upper extremity. At his initial visit, he had a severe chin-on-chest posture. Neurological examination revealed severe paralysis of deltoid, biceps, wrist extensor, finger flexor, extensor, and abductors, in addition to lower extremity spasticity. Nevertheless, sensory dysfunction was not observed. X-ray images showed severe kyphosis at the upper thoracic level. MRI and CT myelography findings revealed spinal canal stenosis at the level of C5–6 and C6 root compression of the right side. Motor neuron disease was excluded because of findings from electromyography. Therefore, we diagnosed this patient as having DHS with cervical spondylotic amyotrophy. A C2–Th5 posterior fusion with C3–C6 laminoplasty and C5–6 foraminotomy on the right side were performed. After surgery, the complaint of dropped head was improved significantly and bilaterally finger motion was improved slightly. His neck position was maintained at the final follow-up at about 1 year after surgery. CONCLUSIONS: Despite the limitation of short-term follow-up, favorable results for the DHS were maintained in the present case. Surgical treatment for similar cases may be a feasible option, but surgery does have some complications. BioMed Central 2018-07-24 /pmc/articles/PMC6057102/ /pubmed/30041689 http://dx.doi.org/10.1186/s13104-018-3612-2 Text en © The Author(s) 2018 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Case Report
Taniguchi, Shinji
Takahashi, Hiroshi
Aoki, Yasuchika
Nakajima, Arata
Terajima, Fumiaki
Sonobe, Masato
Akatsu, Yorikazu
Yamada, Manabu
Furuya, Takeo
Koda, Masao
Yamazaki, Masashi
Ohtori, Seiji
Nakagawa, Koichi
Surgical treatment for dropped head syndrome with cervical spondylotic amyotrophy: a case report
title Surgical treatment for dropped head syndrome with cervical spondylotic amyotrophy: a case report
title_full Surgical treatment for dropped head syndrome with cervical spondylotic amyotrophy: a case report
title_fullStr Surgical treatment for dropped head syndrome with cervical spondylotic amyotrophy: a case report
title_full_unstemmed Surgical treatment for dropped head syndrome with cervical spondylotic amyotrophy: a case report
title_short Surgical treatment for dropped head syndrome with cervical spondylotic amyotrophy: a case report
title_sort surgical treatment for dropped head syndrome with cervical spondylotic amyotrophy: a case report
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6057102/
https://www.ncbi.nlm.nih.gov/pubmed/30041689
http://dx.doi.org/10.1186/s13104-018-3612-2
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