Thomas Caffard, Bruno Verna, Lukas Schönnagel, Ali E Guven, Artine Arzani, Erika Chiapparelli, Marco D Burkhard, Ranqing Lan, Jennifer Shue, Angela Rosenbohm, Jan Kassubek, Oliver Dobrindt, Andrew A Sama, Federico P Girardi, Frank P Cammisa, Timo Zippelius, Alexander P Hughes
{"title":"退行性落头综合征的颈椎肌肉组成:倾向评分匹配研究。","authors":"Thomas Caffard, Bruno Verna, Lukas Schönnagel, Ali E Guven, Artine Arzani, Erika Chiapparelli, Marco D Burkhard, Ranqing Lan, Jennifer Shue, Angela Rosenbohm, Jan Kassubek, Oliver Dobrindt, Andrew A Sama, Federico P Girardi, Frank P Cammisa, Timo Zippelius, Alexander P Hughes","doi":"10.1097/BRS.0000000000005424","DOIUrl":null,"url":null,"abstract":"<p><strong>Study design: </strong>Retrospective cross-sectional.</p><p><strong>Objective: </strong>To compare cervical muscle composition in patients with non-neuromuscular DHS caused by degenerative disease of the cervical spine to patients without DHS who underwent anterior cervical discectomy and fusion (ACDF).</p><p><strong>Summary of background data: </strong>Dropped Head Syndrome (DHS) is characterized by severe weakness of the cervical paraspinal muscles, particularly of the neck extensors that leads to a chin-on-chest deformity. This forward flexion prevents them from lifting their heads against gravity or maintaining a forward gaze, resulting in gait disturbance and impairment in activities of daily life.</p><p><strong>Methods: </strong>Propensity score matching was conducted, calculated based on age, sex, and BMI, to compare cervical muscle fat infiltration (FI) across three groups: 1) patients with DHS, 2) non-DHS patients who underwent 1-2 level ACDF, and 3) non-DHS patients who underwent 3 or more levels of ACDF. The cervical muscles were segmented on axial T2 MRI from C3 to C7 and the percent FI was measured using a previously validated Matlab software.</p><p><strong>Results: </strong>Patients with DHS showed significantly higher FI in the anterior muscle group compared to those undergoing ACDF at all levels (P<0.005) except for C3 (P=0.243). At all levels, patients with DHS demonstrated significantly higher FI in the posterolateral (P<0.001), posteromedial (P<0.01), scalenus (P<0.01), and trapezius muscle groups (P<0.005). At the C4 level, DHS patients had significantly higher FI in the sternocleidomastoid muscle group compared to ACDF groups (P=0.005).</p><p><strong>Conclusion: </strong>This study is the first to quantify FI in the cervical muscles of DHS patients without neurodegenerative/neuromuscular disease. DHS patients showed significant muscular decompensation, with pronounced atrophy in both extensor and anterior muscles compared to ACDF groups. Further studies are needed to explore these relationships and evaluate muscle in DHS with neurodegenerative conditions.</p>","PeriodicalId":22193,"journal":{"name":"Spine","volume":" ","pages":""},"PeriodicalIF":2.6000,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Cervical Muscle Composition in Degenerative Dropped Head Syndrome: A Propensity Score Matching Study.\",\"authors\":\"Thomas Caffard, Bruno Verna, Lukas Schönnagel, Ali E Guven, Artine Arzani, Erika Chiapparelli, Marco D Burkhard, Ranqing Lan, Jennifer Shue, Angela Rosenbohm, Jan Kassubek, Oliver Dobrindt, Andrew A Sama, Federico P Girardi, Frank P Cammisa, Timo Zippelius, Alexander P Hughes\",\"doi\":\"10.1097/BRS.0000000000005424\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Study design: </strong>Retrospective cross-sectional.</p><p><strong>Objective: </strong>To compare cervical muscle composition in patients with non-neuromuscular DHS caused by degenerative disease of the cervical spine to patients without DHS who underwent anterior cervical discectomy and fusion (ACDF).</p><p><strong>Summary of background data: </strong>Dropped Head Syndrome (DHS) is characterized by severe weakness of the cervical paraspinal muscles, particularly of the neck extensors that leads to a chin-on-chest deformity. This forward flexion prevents them from lifting their heads against gravity or maintaining a forward gaze, resulting in gait disturbance and impairment in activities of daily life.</p><p><strong>Methods: </strong>Propensity score matching was conducted, calculated based on age, sex, and BMI, to compare cervical muscle fat infiltration (FI) across three groups: 1) patients with DHS, 2) non-DHS patients who underwent 1-2 level ACDF, and 3) non-DHS patients who underwent 3 or more levels of ACDF. The cervical muscles were segmented on axial T2 MRI from C3 to C7 and the percent FI was measured using a previously validated Matlab software.</p><p><strong>Results: </strong>Patients with DHS showed significantly higher FI in the anterior muscle group compared to those undergoing ACDF at all levels (P<0.005) except for C3 (P=0.243). At all levels, patients with DHS demonstrated significantly higher FI in the posterolateral (P<0.001), posteromedial (P<0.01), scalenus (P<0.01), and trapezius muscle groups (P<0.005). At the C4 level, DHS patients had significantly higher FI in the sternocleidomastoid muscle group compared to ACDF groups (P=0.005).</p><p><strong>Conclusion: </strong>This study is the first to quantify FI in the cervical muscles of DHS patients without neurodegenerative/neuromuscular disease. DHS patients showed significant muscular decompensation, with pronounced atrophy in both extensor and anterior muscles compared to ACDF groups. Further studies are needed to explore these relationships and evaluate muscle in DHS with neurodegenerative conditions.</p>\",\"PeriodicalId\":22193,\"journal\":{\"name\":\"Spine\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":2.6000,\"publicationDate\":\"2025-06-13\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Spine\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1097/BRS.0000000000005424\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"CLINICAL NEUROLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Spine","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1097/BRS.0000000000005424","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}
Cervical Muscle Composition in Degenerative Dropped Head Syndrome: A Propensity Score Matching Study.
Study design: Retrospective cross-sectional.
Objective: To compare cervical muscle composition in patients with non-neuromuscular DHS caused by degenerative disease of the cervical spine to patients without DHS who underwent anterior cervical discectomy and fusion (ACDF).
Summary of background data: Dropped Head Syndrome (DHS) is characterized by severe weakness of the cervical paraspinal muscles, particularly of the neck extensors that leads to a chin-on-chest deformity. This forward flexion prevents them from lifting their heads against gravity or maintaining a forward gaze, resulting in gait disturbance and impairment in activities of daily life.
Methods: Propensity score matching was conducted, calculated based on age, sex, and BMI, to compare cervical muscle fat infiltration (FI) across three groups: 1) patients with DHS, 2) non-DHS patients who underwent 1-2 level ACDF, and 3) non-DHS patients who underwent 3 or more levels of ACDF. The cervical muscles were segmented on axial T2 MRI from C3 to C7 and the percent FI was measured using a previously validated Matlab software.
Results: Patients with DHS showed significantly higher FI in the anterior muscle group compared to those undergoing ACDF at all levels (P<0.005) except for C3 (P=0.243). At all levels, patients with DHS demonstrated significantly higher FI in the posterolateral (P<0.001), posteromedial (P<0.01), scalenus (P<0.01), and trapezius muscle groups (P<0.005). At the C4 level, DHS patients had significantly higher FI in the sternocleidomastoid muscle group compared to ACDF groups (P=0.005).
Conclusion: This study is the first to quantify FI in the cervical muscles of DHS patients without neurodegenerative/neuromuscular disease. DHS patients showed significant muscular decompensation, with pronounced atrophy in both extensor and anterior muscles compared to ACDF groups. Further studies are needed to explore these relationships and evaluate muscle in DHS with neurodegenerative conditions.
期刊介绍:
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Recognized internationally as the leading journal in its field, Spine is an international, peer-reviewed, bi-weekly periodical that considers for publication original articles in the field of Spine. It is the leading subspecialty journal for the treatment of spinal disorders. Only original papers are considered for publication with the understanding that they are contributed solely to Spine. The Journal does not publish articles reporting material that has been reported at length elsewhere.