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Dropped head syndrome after cervical laminoplasty: A case control study
Masao Koda1, Takeo Furuya1, Tomoaki Kinoshita2
1Department of Orthopedic Surgery, Chiba University Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba 260-8677, Japan.
Summary
Patients undergoing cervical laminoplasty may develop dropped head syndrome (DHS) due to pre-existing neck alignment issues. Preoperative kyphosis and sagittal vertical axis are key risk factors for this condition.
Area of Science:
- Orthopedics
- Neurosurgery
- Spinal Surgery
Background:
- Dropped head syndrome (DHS) involves neck extensor muscle weakness, impairing head extension against gravity.
- Cervical laminoplasty is a surgical procedure for spinal decompression.
Purpose of the Study:
- To identify risk factors for developing dropped head syndrome (DHS) after cervical laminoplasty.
- To compare patients with and without DHS post-surgery to determine predictive factors.
Main Methods:
- Retrospective analysis of 5 patients with DHS and 20 controls after cervical laminoplasty.
- Preoperative radiographic assessment of cervical spine alignment (C2-C7 angle, C7-T1 kyphosis, CGH-C7 SVA).
- Preoperative MRI to measure deep extensor muscle cross-sectional area and postoperative CT for lateral gutter width.
Main Results:
- The DHS group showed significantly smaller preoperative C2-C7 angles (less lordosis/more kyphosis).
- The DHS group exhibited significantly larger preoperative C7-T1 kyphosis and CGH-C7 SVA.
- No significant differences were noted in muscle cross-sectional area or lateral gutter width.
Conclusions:
- Preoperative cervical kyphosis (C2-C7 and C7-T1) and an increased head-C7 sagittal vertical axis (CGH-C7 SVA) are significant risk factors for DHS post-laminoplasty.
- Identifying these sagittal alignment parameters preoperatively can help predict patients at higher risk for dropped head syndrome.
