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Dropped head syndrome: report of a rare complication after multilevel bilateral cervical radiofrequency neurotomy
INTRODUCTION: Cervical radiofrequency neurotomy is a safe and relatively low-risk procedure commonly used to treat facet joint–mediated axial neck pain. Severe complications are extremely rare and can be avoided with proper technique and appropriate imaging guidance. This article describes the devel...
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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Wolters Kluwer
2022
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Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9478223/ https://www.ncbi.nlm.nih.gov/pubmed/36128045 http://dx.doi.org/10.1097/PR9.0000000000001037 |
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author | Bajaj, Harnek S. Chapman, Andrew W. |
author_facet | Bajaj, Harnek S. Chapman, Andrew W. |
author_sort | Bajaj, Harnek S. |
collection | PubMed |
description | INTRODUCTION: Cervical radiofrequency neurotomy is a safe and relatively low-risk procedure commonly used to treat facet joint–mediated axial neck pain. Severe complications are extremely rare and can be avoided with proper technique and appropriate imaging guidance. This article describes the development and subsequent management of a case of dropped head syndrome after cervical radiofrequency neurotomy. METHODS: A 77-year-old man with cervicalgia, multilevel facet arthropathy, and a known kyphosis in the setting of cervical degenerative disk disease underwent successful conventional radiofrequency neurotomy to the bilateral C3, C4, and C5 medial branches. No immediate complications were noted. RESULTS: Six weeks subsequent to the procedure, the patient reported difficulty keeping his head erect, and physical examination revealed weakness of the cervical paraspinal musculature, with restriction of active extension to about neutral. A diagnosis of dropped head syndrome was made. The patient was successfully managed with temporary use of soft cervical collar and physical therapy for progressive range of motion and strengthening. DISCUSSION: Dropped head syndrome is a known, but likely underappreciated, complication of cervical radiofrequency neurotomy, with only 2 other cases reported and published in the literature to our knowledge. Mild cases may resolve with conservative management, but this is a potentially debilitating condition that we recommend should be routinely discussed during procedural consent for cervical radiofrequency neurotomy. Future studies should explore specific mitigating factors to reduce the risk of development of this possible complication. |
format | Online Article Text |
id | pubmed-9478223 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Wolters Kluwer |
record_format | MEDLINE/PubMed |
spelling | pubmed-94782232022-09-19 Dropped head syndrome: report of a rare complication after multilevel bilateral cervical radiofrequency neurotomy Bajaj, Harnek S. Chapman, Andrew W. Pain Rep General Section INTRODUCTION: Cervical radiofrequency neurotomy is a safe and relatively low-risk procedure commonly used to treat facet joint–mediated axial neck pain. Severe complications are extremely rare and can be avoided with proper technique and appropriate imaging guidance. This article describes the development and subsequent management of a case of dropped head syndrome after cervical radiofrequency neurotomy. METHODS: A 77-year-old man with cervicalgia, multilevel facet arthropathy, and a known kyphosis in the setting of cervical degenerative disk disease underwent successful conventional radiofrequency neurotomy to the bilateral C3, C4, and C5 medial branches. No immediate complications were noted. RESULTS: Six weeks subsequent to the procedure, the patient reported difficulty keeping his head erect, and physical examination revealed weakness of the cervical paraspinal musculature, with restriction of active extension to about neutral. A diagnosis of dropped head syndrome was made. The patient was successfully managed with temporary use of soft cervical collar and physical therapy for progressive range of motion and strengthening. DISCUSSION: Dropped head syndrome is a known, but likely underappreciated, complication of cervical radiofrequency neurotomy, with only 2 other cases reported and published in the literature to our knowledge. Mild cases may resolve with conservative management, but this is a potentially debilitating condition that we recommend should be routinely discussed during procedural consent for cervical radiofrequency neurotomy. Future studies should explore specific mitigating factors to reduce the risk of development of this possible complication. Wolters Kluwer 2022-09-14 /pmc/articles/PMC9478223/ /pubmed/36128045 http://dx.doi.org/10.1097/PR9.0000000000001037 Text en Copyright © 2022 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of The International Association for the Study of Pain. https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the Creative Commons Attribution License 4.0 (CCBY) (https://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | General Section Bajaj, Harnek S. Chapman, Andrew W. Dropped head syndrome: report of a rare complication after multilevel bilateral cervical radiofrequency neurotomy |
title | Dropped head syndrome: report of a rare complication after multilevel bilateral cervical radiofrequency neurotomy |
title_full | Dropped head syndrome: report of a rare complication after multilevel bilateral cervical radiofrequency neurotomy |
title_fullStr | Dropped head syndrome: report of a rare complication after multilevel bilateral cervical radiofrequency neurotomy |
title_full_unstemmed | Dropped head syndrome: report of a rare complication after multilevel bilateral cervical radiofrequency neurotomy |
title_short | Dropped head syndrome: report of a rare complication after multilevel bilateral cervical radiofrequency neurotomy |
title_sort | dropped head syndrome: report of a rare complication after multilevel bilateral cervical radiofrequency neurotomy |
topic | General Section |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9478223/ https://www.ncbi.nlm.nih.gov/pubmed/36128045 http://dx.doi.org/10.1097/PR9.0000000000001037 |
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