Abstract
Background: Camptocormia (bent spine syndrome) is an acquired postural disease characterized by forward flexion of the thoracolumbar spine. Dropped head syndrome is characterized by severe weakness of the cervical paraspinal muscles, resulting in gradual sagging of the head and culminating in the classic chin-on-chest deformity. Objective: To report, for the first time, a case of dropped head syndrome and camptocormia in the same patient. Methods and results: A 68-years-old man was diagnosed with base tongue squamous cell carcinoma, surgically removed. He had local recurrence and underwent radiosensitive chemotherapy and radiotherapy (35 fractions of 70Gy). After 12 months, he developed progressive cervical extensor muscle weakness, and a flexible chin-on-chest deformity, treated with passive reduction and C3-T3 fixation. Three months later, camptocormia was diagnosed, and initially treated conservatively. Ten months later, the deformity became rigid, and he was operated with Ponte and pedicle subtraction osteotomies in thoracic and lumbar spine, and C3 to sacrum arthrodesis with instrumentation. The patient resumed professional activities by the third month. Oncological screening showed no tumoral recurrence or distant metastases, after one year from last surgery. Conclusion: This is the first report of dropped head syndrome and camptocormia in the same patient, due radiosensibilizing chemotherapy for a nasopharyngeal carcinoma.
Highlights
Camptocormia is an acquired postural disease characterized by forward flexion of the thoracolumbar spine
In a literature review in cases involving Parkinson’s disease and camptocormia, the results showed that there is high rate of complications when spinal surgery is performed
Dropped head syndrome is characterized by severe weakness of the cervical paraspinal muscles, resulting in gradual sagging of the head and culminating in the classic chin-on-chest deformity
Summary
A 68-years-old man was diagnosed with base tongue squamous cell carcinoma, surgically removed. He had local recurrence and underwent radiosensitive chemotherapy and radiotherapy (35 fractions of 70Gy). After 12 months, he developed progressive cervical extensor muscle weakness, and a flexible chin-on-chest deformity, treated with passive reduction and C3-T3 fixation. Camptocormia was diagnosed, and initially treated conservatively. The deformity became rigid, and he was operated with Ponte and pedicle subtraction osteotomies in thoracic and lumbar spine, and C3 to sacrum arthrodesis with instrumentation. The patient resumed professional activities by the third month. Oncological screening showed no tumoral recurrence or distant metastases, after one year from last surgery
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