BMC Musculoskeletal Disorders (Jun 2020)

Impact of Spinopelvic sagittal alignment on the surgical outcomes of dropped head syndrome: a multi-center study

  • Yoshifumi Kudo,
  • Tomoaki Toyone,
  • Kenji Endo,
  • Yuji Matsuoka,
  • Ichiro Okano,
  • Koji Ishikawa,
  • Akira Matsuoka,
  • Hiroshi Maruyama,
  • Ryo Yamamura,
  • Haruka Emori,
  • Soji Tani,
  • Toshiyuki Shirahata,
  • Chikara Hayakawa,
  • Yushi Hoshino,
  • Tomoyuki Ozawa,
  • Hidekazu Suzuki,
  • Takato Aihara,
  • Kazuma Murata,
  • Taichiro Takamatsu,
  • Katsunori Inagaki

DOI
https://doi.org/10.1186/s12891-020-03416-w
Journal volume & issue
Vol. 21, no. 1
pp. 1 – 10

Abstract

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Abstract Background Most of the previous studies about the surgical treatment of dropped head syndrome (DHS) are small case series, and their primary outcome measures were cervical alignment parameters. Therefore, little is known about the associations between pre- and postoperative global sagittal alignment in the whole spine and the clinical outcomes of the surgical treatment of DHS. In this study, we investigated the surgical outcomes of DHS, including correction of cervical and global spinal sagittal alignment. Methods This study was a retrospective observational study. Fifteen patients with DHS who had undergone correction surgery were enrolled. Surgical outcomes, including complications and implant failures, were investigated. We assessed cervical alignment parameters as well as spinopelvic global alignment parameters, including pelvic incidence (PI), lumbar lordosis (LL), and C7-sacral sagittal vertical axis (SVA). We examined the changes in these parameters using pre- and posoperative whole spine lateral radiographs. The parameters were compared between the failure and nonfailure groups. Results Recurrence of sagittal imbalance and horizontal gaze difficulty was observed in 6 cases (40%). In all, 3 cases (20%) exhibited a distal junctional failure and required multiple surgeries with extension of fusion. Of all the radiographic parameters compared between the failure and nonfailure groups, significant differences were only observed in pre and postoperative SVA and PI-LL. Conclusions Our results suggest that the global sagittal alignment parameters, including PI-LL and SVA, were different between the patients with failure and non failure, and these parameters might have notable impacts on surgical outcomes. Surgeons should consider PI-LL and SVA while determining the surgical course for patients with DHS.

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