SURGICAL CORRECTION OF SEVERE AND FIXED CHIN-ON-CHEST DEFORMITY

• Autor(a) principal: Marcon,Raphael Martus
• Data de Publicação: 2018
• Outros Autores: Ono,Allan Hiroshi de Araujo, Zelada,Flávio Gerardo Benites, Cristante,Alexandre Fogaça, Barros Filho,Tarcísio Eloy Pessoa
• Tipo de documento: Artigo
• Idioma: eng
• Título da fonte: Acta Ortopédica Brasileira (Online)
• Texto Completo: http://old.scielo.br/scielo.php?script=sci_arttext&pid=S1413-78522018000600415
• topic: Surgical procedures operative; Spinal diseases; Cervical vertebrae; Osteotomy; Decompression, surgical

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.