Transdiscal Fixation for Dropped Head Syndrome: A Case Report

Dropped head syndrome (DHS) is a rare condition mainly due to neck extensor muscle weakness. The main symptoms of DHS are chin-on-chest deformity, difficulty raising the head against gravity, neck pain, difficulty eating, and difficulty maintaining horizontal gaze. The DHS patients with severe daily life disturbances need surgical intervention, which is usually a long spinal fusion. There are several reports of distal junctional failure due to distal screw loosening, screw pullout, and implant failure because DHS patients are relatively old and may have osteoporosis. To solve this problem, cement-augmented screw fixation is one option. However, due to shoulder shadow, the cervicothoracic junction is complicated to get a clear C-arm image. The report presents the case of a 77-year-old male patient with DHS treated with a novel C-arm-free navigation technique via transdiscal fixation.