Marcon Raphael Martus, Ono Allan Hiroshi de Araujo, Zelada Flávio Gerardo Benites, Cristante Alexandre Fogaça, Barros Tarcísio Eloy Pessoa
Universidade de São Paulo, Faculdade de Medicina, Hospital das Clínicas (IOT-HCFMUSP), Instituto de Ortopedia e Traumatología, Laboratory of Medical investigation, Spine Surgery Division, São Paulo, SP, Brazil.
Acta Ortop Bras. 2018;26(6):415-417. doi: 10.1590/1413-785220182606169271.
To describe a successful surgical treatment for the challenging severe and fixed chin-on-chest deformity due to isolated neck extensor myopathy (INEM).
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.
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.
At the three-months follow-up, there was good deformity correction and the patient's satisfaction was high, with no neurological deterioration occurring.
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.
描述一种针对因孤立性颈部伸肌肌病（INEM）导致的具有挑战性的严重固定性低头畸形的成功手术治疗方法。
INEM是导致头部下垂综合征（DHS）的特发性病因，可导致严重的颈胸段后凸畸形，即低头畸形。现有的关于手术治疗的文献有限，治疗结果从差到优不等。INEM可能会被脊柱外科医生考虑进行手术治疗。
作者介绍了一种采用分期前后路联合截骨术和椎体次全切除术来矫正严重固定畸形的技术。使用了先进的前路和后路内固定系统。
在3个月的随访中，畸形矫正良好，患者满意度高，未发生神经功能恶化。
本研究中阐述的技术是治疗这种使人衰弱的畸形的一种成功选择。需要更多证据来建立针对这种疾病的明确治疗方案。
