Author/Authors :
MaRtus MaRcon, Raphael Universidade de São Paulo - Faculdade de Medicina - Hospital das Clínicas (IOT-HCFMUSP), Instituto de Ortopedia e Traumatologia, Laboratory of Medical Investigation - Spine surgery Division, São Paulo, SP, Brazil , hiRoshi de aRaujo ono, allan Universidade de São Paulo - Faculdade de Medicina - Hospital das Clínicas (IOT-HCFMUSP), Instituto de Ortopedia e Traumatologia, Laboratory of Medical Investigation - Spine surgery Division, São Paulo, SP, Brazil , GeRaRdo Benites Zelada, Flávio Universidade de São Paulo - Faculdade de Medicina - Hospital das Clínicas (IOT-HCFMUSP), Instituto de Ortopedia e Traumatologia, Laboratory of Medical Investigation - Spine surgery Division, São Paulo, SP, Brazil , FoGaça cRistante, alexandRe Universidade de São Paulo - Faculdade de Medicina - Hospital das Clínicas (IOT-HCFMUSP), Instituto de Ortopedia e Traumatologia, Laboratory of Medical Investigation - Spine surgery Division, São Paulo, SP, Brazil , eloy pessoa BaRRos Filho, taRcísio Universidade de São Paulo - Faculdade de Medicina - Hospital das Clínicas (IOT-HCFMUSP), Instituto de Ortopedia e Traumatologia, Laboratory of Medical Investigation - Spine surgery Division, São Paulo, SP, Brazil
Abstract :
Objective: To describe a successful surgical treatment for the
challenging severe and fixed chin-on-chest deformity due to isolated
neck extensor myopathy (INEM). Background data: INEM is an
idiopathic cause of dropped head syndrome (DHS) that results in
severe cervicothoracic kyphosis, defined as chin-on-chest deformity.
The existing literature on surgical management is limited, with
outcomes ranging from poor to excellent. INEM may present to the
spinal surgeon for consideration of surgical management. Methods:
The authors present a technique that uses a staged posterior and
anterior approach combined with osteotomies and corpectomy to
correct the severe and fixed deformity. A state of the art anterior
and posterior instrumentation system was used. Results: At the
three-months follow-up, there was good deformity correction and
the patient’s satisfaction was high, with no neurological deterioration
occurring. Conclusions: The technique illustrated in this study
represents a successful option to treat this debilitating deformity.
More evidence is needed to set up a definitive algorithm for the
management of this condition. Level of evidence IV, Case Report
Keywords :
Surgical procedures operative , Spinal diseases , Cervical vertebrae , Osteotomy , Decompression , surgical
