Dropped Head Syndrome ~Pathology and Treatment~

2023 Fiscal Year Final Research Report

• Project/Area Number: 21K09333
• Research Category: Grant-in-Aid for Scientific Research (C)
• Allocation Type: Multi-year Fund
• Section: 一般
• Review Section: Basic Section 56020:Orthopedics-related
• Research Institution: Showa University
• Principal Investigator: Kudo Yoshifumi 昭和大学, 医学部, 教授 (60621985)
• Co-Investigator(Kenkyū-buntansha): 豊根 知明 昭和大学, 医学部, 教授 (10407918) ; 石川 紘司 昭和大学, 医学部, 講師 (40794946)
• Project Period (FY): 2021-04-01 – 2024-03-31
• Keywords: dropped head syndrome / cervical spine / deformity / degeneration

Outline of Final Research Achievements

In this study, we investigated the characteristics features of cervical spine degeneration of dropped head syndrome (DHS), and found that DHS is not caused by myopathy but also by a high degree of degeneration. In some patients, DHS is caused by malalignment of the thoracolumbar spine, and it was found that correction of the thoracolumbar spine could improve chin-on-chest deformity and horizontal gaze difficulty. In most of the DHS patients with thoracolumbar deformity, compression fractures of the thoracolumbar spine was the trigger of pathology. These results suggested that DHS is also a part of age-related degeneration of the whole body. We also examined P/DJK and dysphagia as surgical complications, and reported that evaluation of total spine alignment, compensatory function, and preoperative swallowing function are important for prevention.

Free Research Field

adult spinal deformity

Academic Significance and Societal Importance of the Research Achievements

日本は超高齢社会に突入しており、今後も首下がり患者は増加の一途をたどると考えられる。本研究結果より、首下がりは単なる頚椎の筋炎に由来する病態ではなく、全身の老化の一部として脊柱変性に伴い発生していることが示唆された。手術成績の検討においては頚椎のみではなく胸腰椎アライメントの評価が非常に重要である事が判明し、胸腰椎の矯正のみで首下がりが改善することも分かった。術前後の嚥下機能を十分に評価することで、術後嚥下障害を予見し重篤な合併症を減らし安全性の向上につながる。これらの結果は今後の手術戦略の確立に大きく寄与すると思われる。