Impact of Spinopelvic sagittal alignment on the surgical outcomes of dropped head syndrome: a multi-center study
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...
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| Format: | Article |
| Language: | English |
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BMC
2020-06-01
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| Series: | BMC Musculoskeletal Disorders |
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| Online Access: | http://link.springer.com/article/10.1186/s12891-020-03416-w |
| _version_ | 1818159481791447040 |
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| author | 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 |
| author_facet | 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 |
| author_sort | Yoshifumi Kudo |
| collection | DOAJ |
| description | 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. |
| first_indexed | 2024-12-11T15:46:40Z |
| format | Article |
| id | doaj.art-51c5aa0719cb4bb7ab205da953a1736b |
| institution | Directory Open Access Journal |
| issn | 1471-2474 |
| language | English |
| last_indexed | 2024-12-11T15:46:40Z |
| publishDate | 2020-06-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Musculoskeletal Disorders |
| spelling | doaj.art-51c5aa0719cb4bb7ab205da953a1736b2022-12-22T00:59:41ZengBMCBMC Musculoskeletal Disorders1471-24742020-06-0121111010.1186/s12891-020-03416-wImpact of Spinopelvic sagittal alignment on the surgical outcomes of dropped head syndrome: a multi-center studyYoshifumi Kudo0Tomoaki Toyone1Kenji Endo2Yuji Matsuoka3Ichiro Okano4Koji Ishikawa5Akira Matsuoka6Hiroshi Maruyama7Ryo Yamamura8Haruka Emori9Soji Tani10Toshiyuki Shirahata11Chikara Hayakawa12Yushi Hoshino13Tomoyuki Ozawa14Hidekazu Suzuki15Takato Aihara16Kazuma Murata17Taichiro Takamatsu18Katsunori Inagaki19Department of Orthopaedic Surgery, Showa UniversityDepartment of Orthopaedic Surgery, Showa UniversityDepartment of Orthopedic Surgery, Tokyo Medical UniversityDepartment of Orthopedic Surgery, Tokyo Medical UniversityDepartment of Orthopaedic Surgery, Showa UniversityDepartment of Orthopaedic Surgery, Showa UniversityDepartment of Orthopaedic Surgery, Showa UniversityDepartment of Orthopaedic Surgery, Showa UniversityDepartment of Orthopaedic Surgery, Showa UniversityDepartment of Orthopaedic Surgery, Showa UniversityDepartment of Orthopaedic Surgery, Showa UniversityDepartment of Orthopaedic Surgery, Showa UniversityDepartment of Orthopaedic Surgery, Showa UniversityDepartment of Orthopaedic Surgery, Showa UniversityDepartment of Orthopaedic Surgery, Showa UniversityDepartment of Orthopedic Surgery, Tokyo Medical UniversityDepartment of Orthopedic Surgery, Tokyo Medical UniversityDepartment of Orthopedic Surgery, Tokyo Medical UniversityDepartment of Orthopedic Surgery, Tokyo Medical UniversityDepartment of Orthopaedic Surgery, Showa UniversityAbstract 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.http://link.springer.com/article/10.1186/s12891-020-03416-wDropped head syndromeChin-on-chest deformitySagittal vertical axisCompensatory functionSurgical outcomeSpinopelvic sagittal alignment |
| spellingShingle | 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 Impact of Spinopelvic sagittal alignment on the surgical outcomes of dropped head syndrome: a multi-center study BMC Musculoskeletal Disorders Dropped head syndrome Chin-on-chest deformity Sagittal vertical axis Compensatory function Surgical outcome Spinopelvic sagittal alignment |
| title | Impact of Spinopelvic sagittal alignment on the surgical outcomes of dropped head syndrome: a multi-center study |
| title_full | Impact of Spinopelvic sagittal alignment on the surgical outcomes of dropped head syndrome: a multi-center study |
| title_fullStr | Impact of Spinopelvic sagittal alignment on the surgical outcomes of dropped head syndrome: a multi-center study |
| title_full_unstemmed | Impact of Spinopelvic sagittal alignment on the surgical outcomes of dropped head syndrome: a multi-center study |
| title_short | Impact of Spinopelvic sagittal alignment on the surgical outcomes of dropped head syndrome: a multi-center study |
| title_sort | impact of spinopelvic sagittal alignment on the surgical outcomes of dropped head syndrome a multi center study |
| topic | Dropped head syndrome Chin-on-chest deformity Sagittal vertical axis Compensatory function Surgical outcome Spinopelvic sagittal alignment |
| url | http://link.springer.com/article/10.1186/s12891-020-03416-w |
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