Dropped head syndrome: report of a rare complication after multilevel bilateral cervical radiofrequency neurotomy
Abstract:. Introduction:. Cervical radiofrequency neurotomy is a safe and relatively low-risk procedure commonly used to treat facet joint–mediated axial neck pain. Severe complications are extremely rare and can be avoided with proper technique and appropriate imaging guidance. This article describ...
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| Format: | Article |
| Language: | English |
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Wolters Kluwer
2022-10-01
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| Series: | PAIN Reports |
| Online Access: | http://journals.lww.com/painrpts/fulltext/10.1097/PR9.0000000000001037 |
| _version_ | 1828170489091063808 |
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| author | Harnek S. Bajaj Andrew W. Chapman |
| author_facet | Harnek S. Bajaj Andrew W. Chapman |
| author_sort | Harnek S. Bajaj |
| collection | DOAJ |
| description | Abstract:. Introduction:. Cervical radiofrequency neurotomy is a safe and relatively low-risk procedure commonly used to treat facet joint–mediated axial neck pain. Severe complications are extremely rare and can be avoided with proper technique and appropriate imaging guidance. This article describes the development and subsequent management of a case of dropped head syndrome after cervical radiofrequency neurotomy.
Methods:. A 77-year-old man with cervicalgia, multilevel facet arthropathy, and a known kyphosis in the setting of cervical degenerative disk disease underwent successful conventional radiofrequency neurotomy to the bilateral C3, C4, and C5 medial branches. No immediate complications were noted.
Results:. Six weeks subsequent to the procedure, the patient reported difficulty keeping his head erect, and physical examination revealed weakness of the cervical paraspinal musculature, with restriction of active extension to about neutral. A diagnosis of dropped head syndrome was made. The patient was successfully managed with temporary use of soft cervical collar and physical therapy for progressive range of motion and strengthening.
Discussion:. Dropped head syndrome is a known, but likely underappreciated, complication of cervical radiofrequency neurotomy, with only 2 other cases reported and published in the literature to our knowledge. Mild cases may resolve with conservative management, but this is a potentially debilitating condition that we recommend should be routinely discussed during procedural consent for cervical radiofrequency neurotomy. Future studies should explore specific mitigating factors to reduce the risk of development of this possible complication. |
| first_indexed | 2024-04-12T03:11:05Z |
| format | Article |
| id | doaj.art-94ec9d8875f440a7b167b989d8667e75 |
| institution | Directory Open Access Journal |
| issn | 2471-2531 |
| language | English |
| last_indexed | 2024-04-12T03:11:05Z |
| publishDate | 2022-10-01 |
| publisher | Wolters Kluwer |
| record_format | Article |
| series | PAIN Reports |
| spelling | doaj.art-94ec9d8875f440a7b167b989d8667e752022-12-22T03:50:21ZengWolters KluwerPAIN Reports2471-25312022-10-0175e103710.1097/PR9.0000000000001037202210000-00012Dropped head syndrome: report of a rare complication after multilevel bilateral cervical radiofrequency neurotomyHarnek S. Bajaj0Andrew W. Chapman1a Department of Physical Medicine and Rehabilitation, Pain Medicine, Virginia Commonwealth University Health System, Richmond, VA, USAb Department of Anesthesiology, Chronic Pain Division, Virginia Commonwealth University Health System, Richmond, VA, USAAbstract:. Introduction:. Cervical radiofrequency neurotomy is a safe and relatively low-risk procedure commonly used to treat facet joint–mediated axial neck pain. Severe complications are extremely rare and can be avoided with proper technique and appropriate imaging guidance. This article describes the development and subsequent management of a case of dropped head syndrome after cervical radiofrequency neurotomy. Methods:. A 77-year-old man with cervicalgia, multilevel facet arthropathy, and a known kyphosis in the setting of cervical degenerative disk disease underwent successful conventional radiofrequency neurotomy to the bilateral C3, C4, and C5 medial branches. No immediate complications were noted. Results:. Six weeks subsequent to the procedure, the patient reported difficulty keeping his head erect, and physical examination revealed weakness of the cervical paraspinal musculature, with restriction of active extension to about neutral. A diagnosis of dropped head syndrome was made. The patient was successfully managed with temporary use of soft cervical collar and physical therapy for progressive range of motion and strengthening. Discussion:. Dropped head syndrome is a known, but likely underappreciated, complication of cervical radiofrequency neurotomy, with only 2 other cases reported and published in the literature to our knowledge. Mild cases may resolve with conservative management, but this is a potentially debilitating condition that we recommend should be routinely discussed during procedural consent for cervical radiofrequency neurotomy. Future studies should explore specific mitigating factors to reduce the risk of development of this possible complication.http://journals.lww.com/painrpts/fulltext/10.1097/PR9.0000000000001037 |
| spellingShingle | Harnek S. Bajaj Andrew W. Chapman Dropped head syndrome: report of a rare complication after multilevel bilateral cervical radiofrequency neurotomy PAIN Reports |
| title | Dropped head syndrome: report of a rare complication after multilevel bilateral cervical radiofrequency neurotomy |
| title_full | Dropped head syndrome: report of a rare complication after multilevel bilateral cervical radiofrequency neurotomy |
| title_fullStr | Dropped head syndrome: report of a rare complication after multilevel bilateral cervical radiofrequency neurotomy |
| title_full_unstemmed | Dropped head syndrome: report of a rare complication after multilevel bilateral cervical radiofrequency neurotomy |
| title_short | Dropped head syndrome: report of a rare complication after multilevel bilateral cervical radiofrequency neurotomy |
| title_sort | dropped head syndrome report of a rare complication after multilevel bilateral cervical radiofrequency neurotomy |
| url | http://journals.lww.com/painrpts/fulltext/10.1097/PR9.0000000000001037 |
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