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Spinal Sagittal Alignment in Patients With Dropped Head Syndrome
Kazuma Murata1, Endo Kenji, Hidekazu Suzuki
1Department of Orthopedic Surgery, Tokyo, Medical University, Tokyo, Japan.
Spine
|April 18, 2018
Summary
Isolated neck extensor myopathy (INEM) dropped head syndrome (DHS) shows increased head-axis offset. This spinal sagittal malalignment is influenced by C2 slope, T1 slope, and thoracic kyphosis, impacting daily living.
Area of Science:
- Spine surgery
- Radiographic analysis
- Neuromuscular disorders
Background:
- Dropped head syndrome (DHS) causes chin-on-chest deformity, significantly impairing daily activities.
- Isolated neck extensor myopathy (INEM) is a form of DHS, but its spinal sagittal alignment is poorly understood.
- Literature on the spinal sagittal alignment in INEM DHS is scarce.
Purpose of the Study:
- To investigate and clarify the spinal sagittal alignment in patients with INEM DHS.
- To compare spinal sagittal parameters between INEM DHS patients and a control group.
Main Methods:
- Retrospective radiographic study of 37 INEM DHS patients and 61 cervical spondylosis controls.
- Measurements included C2 slope (C2S), C2-C7 sagittal vertical axis (SVA), T1 slope (T1S), thoracic kyphosis (TK), and pelvic parameters.
- Radiographic parameters were analyzed to determine spinal sagittal alignment characteristics.
Main Results:
- INEM DHS patients exhibited significantly greater C2-C7 SVA (52.0 mm vs. 18.6 mm) compared to controls.
- C2S (52.6° vs. 13.0°) and T1S (37.3° vs. 22.7°) were significantly larger in INEM DHS.
- C2-C7 angle (A) was smaller in INEM DHS (-7.8° vs. 15.2°). C2S, T1S, and T1-T4 TK correlated positively with C2-C7 SVA.
Conclusions:
- INEM DHS is characterized by an increased offset of the head's gravity axis (C2-C7 SVA).
- This magnified head-axis offset is associated with enlarged C2S, T1S, and T1-T4 TK.
- Cervical kyphosis (C2-C7 A) correlates with C2-C7 SVA, suggesting it's an anthropometric characteristic in affected individuals.
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